Osteoporosis during Menopause

Osteoporosis, hot flashes, weight gain, depression – these and more are the bugbears of menopause. You can do nothing against menopause, but very much with a healthy diet and exercise against almost all symptoms. Additional hormones are not necessary. A certain uneasiness probably creeps over all women when they think of the upcoming menopause. And those who are already in the middle of it struggle with very different problems, feeling helplessly exposed to this profound phase of their lives. What osteoporosis has to do with menopause and what helps against it, read here.

What is menopause, anyway?

Fact: Menopause, also called the climacteric or menopause, is characterized by a permanent decline in hormone production (estrogen and progesterone). This stage of life hits most women sometime between the ages of 45 and 50, or more extremely, between 40 and 55. Of the 85 percent of women who experience any symptoms at all, 25 percent suffer from severe menopausal symptoms: These include hot flashes, unstable moods and even depression, less desire for sex, sleep disturbances and headaches. In addition, fatigue, cardiovascular problems, altered menstrual periods, drier skin or weight gain may occur.

Osteoporosis during menopause

Another common accompanying symptom is a decrease in bone density – the dreaded osteoporosis. This occurs when the constant alternation between bone formation and bone resorption in the body is disturbed. This reduces the density of the bones, which is why they become porous and break more easily. Osteoporosis is a common problem in menopausal women, due to the lack of estrogen triggered by menopause. This is because estrogens control the absorption of calcium into the bones. Calcium, in turn, is central to building bone, or the bone tissue that stabilizes it. Just think: 99 percent of the body’s total calcium content is stored in the bones. And it is understandable that when bone mass diminishes, the bone loses its stability. Painful bone fractures, changes in the spine, a hunchback (also known as the not-so-flattering “widow’s hump”) are the consequences.

Additional hormones through hormone replacement therapy?

Against the symptoms occurring during menopause, the hormone estrogen can be prescribed to artificially correct the hormone level. Called hormone replacement therapy, or HRT for short, it has been used since the 1960s to treat symptoms that arise due to estrogen deficiency. As monotherapy or combination therapy (together with the luteal hormone progestin), estrogens are used as menopausal medications in the form of gels, creams, patches or tablets. Estrogens are not suitable for the treatment of already existing, i.e. manifest, postmenopausal osteoporosis. They can only be used to prevent osteoporosis. But here, too, caution is advised: According to a study published in 2002 by the Women’s Health Initiative (WHI), HRT has numerous side effects. It is suspected of significantly increasing the risk of breast cancer and diseases of the heart and vascular system. Hormone replacement therapy to prevent osteoporosis is therefore usually recommended only if the affected person is already at increased risk for bone fractures and other medications cannot be taken because of intolerances or interactions with other drugs.

Phytoestrogens as an alternative to hormone replacement therapy

Various studies have now demonstrated the effect of so-called phytoestrogens in the treatment of postmenopausal osteoporosis. These plant substances, which include isoflavones and lignans, for example, have an estrogen-like effect. They are found, for example, in the following foods:

  • Soybeans and tofu, respectively.
  • Flaxseed
  • Berries
  • Cow’s milk
  • Dried fruit
  • Sesame
  • Garlic

However, the extent to which with the help of phytoestrogens can also prevent the development of osteoporosis in menopause, is not yet sufficiently scientifically clarified.Osteoporosis: 11 tips for strong bones

Other forms of treatment for postmenopausal osteoporosis

Another important group of agents used specifically to prevent and treat postmenopausal osteoporosis are so-called Selective Estrogen Receptor Modulators, or SERMs. These inhibit bone resorption and reduce the incidence of bone fractures. According to current knowledge, there are also significantly fewer side effects than is usual with HRT. Special antibody preparations administered twice a year by injection are also becoming increasingly popular in the treatment of osteoporosis during menopause. The antibody denosumab in particular can increase bone density and thus reduce the risk of bone fractures. In addition, the usual drugs used during osteoporosis treatment can be used. In addition to painkillers, these include calcium and vitamin D3 preparations as well as bisphosphonates, which are intended to reduce the risk of bone fractures.

Preventing osteoporosis through diet and exercise

You can help prevent the development of osteoporosis with a few simple rules of behavior. This includes a balanced diet with plenty of calcium. Although the foundation for stable bones is laid in childhood, it is never too late to eat a diet rich in calcium. The following foods contain particularly high levels of calcium:

  • Milk and dairy products
  • Sesame and nuts
  • Vegetables, such as broccoli, leeks and kale (generally green leafy vegetables).
  • Whole grain products
  • Parsley and dill

It is important that the calcium is supplied throughout the day, such as several small dairy meals a day or additional calcium supplements. In addition, one should be careful not to take too much phosphate, as contained in processed cheese, sausages and meat products. Phosphate in fact worsens the absorption of calcium. Apart from all other positive effects on menopausal health, sport is an excellent protection against osteoporosis. Not only does it strengthen the bones, but exercise in the fresh air also promotes the formation and vitamin D, which in turn promotes the build-up of calcium in the bones. For example, tennis or walking are suitable.