Osteoporosis

Osteoporosis is a condition where bones become weak, brittle, and prone to fractures due to loss of density.Common fracture sites: hips, spine, and wrists. After menopause, declining oestrogen levels accelerate bone loss, increasing osteoporosis risk. Often called a “silent disease” because bone loss occurs without symptoms until a fracture happens.1 in 3 women over 50 will experience an osteoporotic fracture in their lifetime.

Why Are Post-Menopausal Women at Risk?

• Oestrogen decline: Oestrogen protects bones; its reduction post-menopause speeds up bone breakdown.
• Age: Bone density peaks around age 30 and naturally declines with age.
• Other risk factors:
  • Family history of osteoporosis.
  • Low body weight or petite frame.
  • Smoking, excessive alcohol, or sedentary lifestyle.
  • Low calcium/vitamin D intake.

• Bone Density Scan (DEXA scan):
  • Measures bone mineral density (BMD) at the hip and spine.
  • Results are given as a T-score:
    • -1.0 to -2.5: Osteopenia (low bone mass).
    • Below -2.5: Osteoporosis.
• FRAX Tool: Estimates your 10-year fracture risk using age, weight, and medical history.

Managing & Preventing Bone Loss

Lifestyle Changes

• Nutrition:
  • Calcium: Aim for 1,200 mg/day (dairy, leafy greens, fortified foods).
  • Vitamin D: 800–1,000 IU/day (sunlight, fatty fish, supplements).
• Exercise:
  • Weight-bearing activities: Walking, dancing, or stair climbing (30 mins/day).
  • Strength training: Builds muscle to support bones (2–3x/week).
• Avoid smoking and limit alcohol to 1 drink/day.

Medical Treatments

• Bisphosphonates (e.g., alendronate): Slow bone breakdown.
• Hormone Replacement Therapy (HRT): May be prescribed short-term for severe menopausal symptoms and bone protection.
• Other options: Denosumab, teriparatide, or SERMs (raloxifene).

Fall Prevention

• Remove tripping hazards at home.
• Wear supportive shoes.
• Use assistive devices (e.g., cane) if unsteady.

Monitoring Your Bone Health

• Regular DEXA scans: Every 1–2 years if diagnosed with osteoporosis/osteopenia.
• Blood tests: Check vitamin D, calcium, and kidney function.

Q: Can osteoporosis be reversed?
A: While bone loss can’t be fully reversed, treatments can slow progression and reduce fracture risk.

Q: Are supplements safe?
A: Calcium/vitamin D supplements are generally safe but consult your doctor to avoid over-supplementation.

Q: Do medications have side effects?
A: Some (e.g., bisphosphonates) may cause heartburn or rare jawbone issues. Discuss risks/benefits with your doctor.

eGynaecologist Advice:

• You should seek gynaecological consultation about potential benefits and risks of hormone replacement therapy (HRT) after menopause
• You should consider having regular bone density scans to monitor your bone health and discuss this with gynaecologist in your annual health check