All the women who come to the menopause They begin to experience changes in their bodies due to the hormonal fluctuations that come with this stage of life. These changes not only affect the menstrual cycle or mood, but also... bone healthwhich can become more fragile if not properly cared for.
Reducing the production of estrogen It increases the risk of developing chronic diseases, such as cancer, diabetes, and, most notably, osteoporosisOsteoporosis is a disease that requires special attention because the loss of hormones leads to a decrease in levels of Bone densityThis increases the risk of developing this condition and suffering fractures even with minor trauma.
It has been determined that during the first few years after the definitive cessation of menstruation, women may experience a reduction of bone mass especially intense. In fact, studies show that this decline is most pronounced during the first five years after menopause, so the prevention It is necessary in order to adopt good habits that allow you to keep your bones healthy and minimize the likelihood of fractures in adulthood.
During the first years of life and up to early adulthood, the body has the ability to maintain a equilibrium between the reduction of bone mass and the production of new mass. This accumulation phase allows reaching what is called peak bone massThat is, the maximum amount of bone tissue a person will have. Generally, this peak is reached around age 30; then, between 30 and 35, bone loss can begin to outpace the body's production, which is why it's important to start boosting bone density with exercise. exerciseproper nutrition and healthy lifestyles.
Thanks to the suppression of menses At the time of menopause, bone loss accelerates considerably, and as estrogen levels decline, bones become more fragile and susceptible to fractures. This phase is considered a period of rapid bone loss, especially critical in the first few years after menstruation ceases, where bone mineral density can decline much faster than due to chronological age alone.
Women who have a family history of osteopenia or osteoporosis are more at risk of developing this problem. It is convenient to know that once it has been lost bone mass it is difficult to get it back. However, to reduce the risks, it is possible to adopt a healthier lifestyle that allows it to be maintained so as not to compromise the health of the bones.
Bone density loss during menopause: what happens to the bone
Although it may seem otherwise, bone is not an inert structure: it is a living tissue in constant spare partThere are two main types of cells involved in this process:
- OsteoclastsThese are the cells responsible for destroying old or damaged bone, a process called bone resorption.
- OsteoblastsThese are the cells that form new bone, filling in the areas where osteoclasts have worked, which is known as bone formation.
The balance between resorption and formation is called bone remodelingUnder normal conditions, this turnover maintains a stable skeletal structure. However, when estrogen levels decline, as happens during menopause, this balance is disrupted.
- Increase the osteoclast activity and bone is destroyed more rapidly.
- Does it decrease or not increase to the same extent? osteoblast activityTherefore, less new bone is formed.
As a result, the body begins to lose Bone mineral densityThis loss can be especially pronounced in certain types of bone. Trabecular bone, which is more spongy and has a high internal surface area (such as that of the vertebrae and certain areas of the hip), is affected most rapidly, which explains the increase in vertebral fractures and hip in postmenopausal women.
It is important to note that this menopause-related bone loss is in addition to the progressive reduction in bone mass that already occurs with aging. Therefore, menopause is considered a critical phase in a woman's life, in which... rate of bone loss It is usually greater than what would correspond to biological age alone.
Factors that increase the risk of bone loss during menopause
Not all women experience the same loss of bone density or develop osteoporosis, but certain factors increase the risk. bone vulnerability at this stage:
- Family background of osteopenia, osteoporosis or fragility fractures.
- Early menopause, whether natural or induced by medical treatments, which exposes the bone to a longer period without the protection of estrogens.
- low body weight or very thin constitution, which are associated with a lower reserve of bone mass.
- Smoking and high consumption of alcohol or caffeine, which interfere with bone metabolism.
- Sedentary lifestyle and absence of load or resistance exercise, which reduces the mechanical stimulus needed to keep bone strong.
- Diet low in calcium and vitamin Dor intestinal absorption problems that limit the entry of these nutrients.
- Prolonged use of osteopenizing drugs, such as certain corticosteroids or drugs used in cancer treatments.
- Presence of chronic diseases endocrine, inflammatory or digestive conditions that affect calcium and bone metabolism.
The more risk factors present in a single person, the greater the likelihood that bone loss during menopause will be rapid and severe, and that other health problems will arise. osteoporotic fractures in the spine, hip, or wrist.
How is bone density loss diagnosed during menopause?
Decreased bone density is largely a disease silentIt does not produce pain or clear symptoms until a fracture or vertebral deformity occurs. For this reason, it is essential to seek medical advice. diagnostic tests when risk factors are present or the recommended age is reached.
The reference technique for assessing bone mineral density is the bone densitometry, also called a DEXA or DXA scan. It is a quick and painless test that uses a very low amount of radiation to measure the amount of mineral present in bones, especially in the lumbar spine and hip, areas where fractures are more relevant.
The results are expressed using:
- An T-score, which compares your bone density to that of a healthy young adult population of the same sex.
- An Z-score, which compares your bone density to what would be expected in people of your same age, sex and characteristics.
In postmenopausal women, the following values ​​are commonly used: T score to classify the bone condition:
- Value considered normal when the T-score is equal to or greater than -1.
- Osteopenia When the T-score is between -1 and -2,5, it indicates a lower than normal bone mass, but without reaching osteoporosis.
- Osteoporosis When the T-score is equal to or less than -2,5, it implies significant bone loss and a high risk of fractures.
Based on these results, the presence of previous fractures, and individual risk factors, the healthcare professional can recommend from intensive preventive measures including specific drug treatments that reduce bone resorption or stimulate the formation of new bone.
Habits and care to slow bone loss during menopause
Once the mechanisms of bone density loss during menopause are understood, the goal is to act on all those aspects that can be modified with changes in the lifestyle and, when necessary, with pharmacological support or supplementation.
- regular physical exerciseWeight-bearing activities (brisk walking, climbing stairs, dancing, hiking) and strength training Using weights or resistance bands helps maintain and, in some cases, increase bone density. Balance and flexibility exercises (yoga, tai chi) reduce the risk of falls.
- Calcium-rich dietIncluding dairy products, fortified drinks, small fish that are eaten with the bones, leafy green vegetables, nuts and legumes promotes a sufficient intake of this essential mineral for bone.
- Adequate Vitamin DModerate sun exposure and consumption of foods containing it, in addition to supplements if the professional considers it necessary, improve calcium absorption and muscle function.
- Body weight controlAvoiding both extreme low weight and obesity helps reduce the risk of fractures and joint overload.
- Avoid tobacco and excessive alcoholQuitting smoking and moderating alcohol consumption are fundamental measures to protect bone structure.
In some cases, especially when bone density scans already show marked osteopenia or osteoporosis, the specialist may consider prescribing calcium and vitamin D supplementsHormone therapy, antiresorptive medications (such as certain bisphosphonates), or other treatments that help slow down bone loss to improve bone quality.
Maintaining bone density during menopause means combining information, prevention, and medical monitoring: the sooner healthy habits are adopted and any decrease in bone mass is detected, the greater the chances of maintaining good bone density. strong and functional bones in the long term and to enjoy this stage of life with autonomy and a good quality of life.