“Women are at a greater risk of developing osteoporosis because of the rapid decline in oestrogen levels during menopause. When oestrogen levels decrease, bones…”.1

Umbrella
What may the Osteoporosis Risk and Prevention Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Osteoporosis Prevention
  • Osteoporosis Risk
  • Osteoporosis Risk Factors

Women

Is there an association between women and the risk of developing osteoporosis?

In What Women Need To Know the (United States) National Osteoporosis Foundation (NOF) note:

“Being female puts you at risk of developing osteoporosis and broken bones. Here are some facts:

  • Of the estimated 10 million Americans with osteoporosis, about eight million or 80% are women
  • Approximately one in two women over age 50 will break a bone because of osteoporosis
  • A woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer”.2

Women’s Risk Factors

What are women’s risk factors for developing osteoporosis?

In Osteoporosis and Arthritis: Two Common But Different Conditions – Osteoporosis the (United States National Institutes of Health) National Institute of Arthritis, and Musculoskeletal and Skin Diseases’ NIH Osteoporosis and Related Bone Diseases National Resource Center explain:

“Risk factors for developing osteoporosis include:

  • Thinness or small frame
  • Family history of the disease
  • Being postmenopausal and particularly having had early menopause
  • Abnormal absence of menstrual periods (amenorrhea)
  • Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
  • Low calcium intake
  • Lack of physical activity
  • Smoking
  • Excessive alcohol intake”.3

In Are You At Risk? the NOF explain:

“Uncontrollable Risk Factors

  • Being over age 50
  • Being female
  • Menopause
  • Family history of osteoporosis
  • Low body weight/being small and thin
  • Broken bones or height loss
Controllable Risk Factors

  • Not getting enough calcium and vitamin D
  • Not eating enough fruits and vegetables
  • Getting too much protein, sodium and caffeine
  • Having an inactive lifestyle
  • Smoking
  • Drinking too much alcohol
  • Losing weight”.4

The (Australian) Jean Hailes for Women’s Health also note:

“Smoking, lack of exercise, alcohol and high caffeine intake (5-6 cups of coffee or caffeinated soft drinks per day) can increase the risk of osteoporosis”.5

Menopause

Is there an association between menopause and the risk of developing osteoporosis?

In What Women Need To Know: Menopause: A Time for Action the NOF elaborate on:

National Osteoporosis Month May 2020
“When a woman reaches menopause, her estrogen levels drop and can lead to bone loss. For some women, this bone loss is rapid and severe.
Two major factors that affect your chance of getting osteoporosis are:

  • The amount of bone you have when you reach menopause
  • How fast you lose bone after you reach menopause…”.6

Prevention

What is the key strategy for preserving bone mass after menopause?

On page three in Maintaining Health and Preventing Disease After the Menopause: Reducing the Risks of Osteoporosis and Osteoarthritis Post Menopause the IMS elaborate on:

“Lifestyle and diet is the key strategy for preserving bone mass after menopause. Smoking and excessive alcohol use are toxic to bones and should be avoided. Moderate daily weight-bearing exercise strengthens bones and is recommended”.7

In Prevention and Healthy Living the NOF elaborate on:

“What Can You Do To Protect Your Bones?

  • Get enough calcium and vitamin D and eat a well balanced diet
  • Engage in regular exercise
  • Eat foods that are good for bone health, such as fruits and vegetables
  • Avoid smoking and limit alcohol to 2-3 drinks per day”.8

Bone Exercise

What is the best exercise for your bones?

In Exercise for Your Bone Health: The Best Bone Building Exercises NIH Osteoporosis and Related Bone Diseases National Resource Center note:

“Weight-bearing and resistance exercises are the best for your bones. Weight-bearing exercises force you to work against gravity. They include walking, hiking, jogging, climbing stairs, playing tennis, and dancing. Resistance exercises – such as lifting weights – can also strengthen bones. Other exercises such as swimming and bicycling can help build and maintain strong muscles and have excellent cardiovascular benefits, but they are not the best way to exercise your bones”.9

Hormone Therapy and Bone Loss

Is menopausal hormone therapy (MHT) effective in the prevention of bone loss?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy – endorsed by seven menopause-related organizations – published online 20 June 2016 is:

  • “MHT, including tibolone and CE/BZA, is effective in the prevention of bone loss in postmenopausal women”.10

What is CE/BZA?

CE/BZA can be an abbreviation for Conjugated Equine Estrogens and Bazedoxifene.

Hormone Therapy and Fractures

Can MHT lower the risk of fractures?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy is:

  • “MHT has been shown to significantly lower the risk of hip, vertebral and other osteoporosis-related fractures in postmenopausal women”.11

Hormone Therapy and Osteoporosis

Can MHT lower the risk of osteoporosis?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy is:

  • “MHT, including tibolone, can be initiated in postmenopausal women at risk of fracture or osteoporosis before the age of 60 years or within 10 years after menopause”.12

Health Care Provider

What if I think I am at risk for osteoporosis?

If you think you are at risk for osteoporosis, it may be in your best interest to choose to talk to your health care provider about this. In Menopause FAQs: Your Health After Menopause – Q. What Can I Do To Prevent Osteoporosis? the North American Menopause Society encourage us to:

“Talk to your healthcare provider about your risk of osteoporosis and what you can do to help keep your bones strong, especially with good nutrition and exercise”.13

The NIH Osteoporosis and Related Bone Diseases National Resource Center explain:

“Remember, exercise is only one part of an osteoporosis prevention or treatment program. Like a diet rich in calcium and vitamin D, exercise helps strengthen bones at any age. But proper exercise and diet may not be enough to stop bone loss caused by medical conditions, menopause, or lifestyle choices such as tobacco use and excessive alcohol consumption. It is important to speak with your doctor about your bone health. Discuss whether you might be a candidate for a bone mineral density test. If you are diagnosed with low bone mass, ask what medications might help keep your bones strong”.14

Health Topics A-Z

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Risk Factors: More Information on Risk Factors. Last Updated: 23 February 2017. Osteoporosis Australia https://www.osteoporosis.org.au/risk-factors Accessed: 27 April 2020
  2. What Women Need To Know. National Osteoporosis Foundation https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/ Accessed: 27 April 2020
  3. Osteoporosis and Arthritis: Two Common But Different Conditions – Osteoporosis. Last Reviewed: December 2018. NIH Osteoporosis and Related Bone Diseases National Resource Center https://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/osteoporosis_arthritis.asp Accessed: 27 April 2020
  4. Are You At Risk? National Osteoporosis Foundation https://www.nof.org/prevention/general-facts/bone-basics/are-you-at-risk/ Accessed: 27 April 2020
  5. Health After Menopause: Bone Health & Osteoporosis. Last Updated: 14 January 2020 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/health-after-menopause/ Accessed: 27 April 2020
  6. What Women Need To Know: Menopause: A Time for Action. National Osteoporosis Foundation https://www.nof.org/prevention/general-facts/what-women-need-to-know/ Accessed: 27 April 2020
  7. Maintaining Health and Preventing Disease After the Menopause: Reducing the Risks of Osteoporosis and Osteoarthritis Post Menopause. 2014:3. International Menopause Society https://www.imsociety.org/downloads/world_menopause_day_2014/booklets/ims_wmd_booklet_2014_english.pdf Accessed: 27 April 2020
  8. Prevention and Healthy Living. Last Reviewed 08/09/2018. National Osteoporosis Foundation https://www.nof.org/preventing-fractures/prevention/prevention-and-healthy-living/ Accessed: 27 April 2020
  9. Exercise for Your Bone Health: The Best Bone Building Exercise. Last Reviewed: October 2018. NIH Osteoporosis and Related Bone Diseases National Resource Center https://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Exercise/default.asp Accessed: 27 April 2020
  10. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 27 April 2020
  11. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 27 April 2020
  12. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 27 April 2020
  13. Menopause FAQs: Your Health After Menopause – Q. What can I do to prevent osteoporosis? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-your-health-after-menopause Accessed: 27 April 2020
  14. Exercise for Your Bone Health: A Complete Osteoporosis Program. Last Reviewed: October 2018. NIH Osteoporosis and Related Bone Diseases National Resource Center https://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Exercise/default.asp Accessed: 27 April 2020
Topic Last Updated: 27 April 2020 – Topic Last Reviewed: 27 April 2020
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