There are no big clues to this one. Your back might be hurting, you may have spotted that your posture isn’t what it was, or perhaps you’ve noticed you’re getting shorter…or you may have a bone fracture with what could be considered a low impact injury.
But most commonly, there won’t be any pain or signs. The first time you’ll realise you have osteoporosis is when you break a bone without having any sort of accident.
Sounds a bit alarming, doesn’t it? Yes, osteoporosis, literally translated from Greek as ‘porous bones’, can creep up on you.
This condition develops over several years and is often only diagnosed when people have a minor bump and fracture something. As osteoporosis worsens, everyday activities like standing, walking and bending may be enough to cause a broken bone. Sometimes even a cough can bust a rib. Ouch.
Women’s bones can weaken more rapidly in the first few years after their periods stop. And you are more at risk if they scarpered before you turned 45.
So why is this? Why does the risk of osteoporosis increase with the menopause? It’s down to a lack of pesky oestrogen again, as this hormone is essential for healthy bones. That’s why if you over-exercise or diet drastically before the menopause, causing your periods to stop for six months or longer, you can be at risk of osteoporosis too.
It’s not unique to women in the menopause – three million people in the UK have osteoporosis, albeit more women than men. Some women can get premenopausal osteoporosis, but it most often comes on with age.
You don’t have to accept that you are at a higher risk of this condition as you age or as your hormones rearrange themselves.
No matter how old you are, you can keep your bones strong and prevent osteoporosis during the menopause.
DO A RISK ASSESSMENT
Do you know if you are at a higher risk of developing osteoporosis?
Check out your family history – have either of your parents had hip fractures? What about you? Have you been taking high-dose corticosteroids for a long time (anti-inflammatory medications that treat a host of conditions like arthritis and asthma)? Do you know if you have a problem absorbing calcium? Or a general malabsorption problem as part of coeliac or Crohn's disease?
Do you have an eating disorder or a low body mass index (BMI) of 19 or less? Do you drink or smoke heavily?
If you’ve ticked one or more of the above, it might be worth having a conversation with your doctor, who can assess your risk and perhaps offer a bone mineral density scan and any necessary treatment.
PREVENTION IS BETTER THAN THE CURE
We keep saying this a lot, but the better you take care of yourself, the more chance you have of top trumping the majority of menopausal symptoms.
You can ward off weedy bones if you eat healthily and include the right things in your diet. Dairy foods, green leafy vegetables, fortified soya products and cereals, and fish like anchovies and sardines, where you eat the bones, will give you a vital hit of calcium.
Meanwhile, helpings of oily fish like salmon, herring and mackerel, red meat and offal, egg yolks, fortified cereals, soya products and spreads will make sure you get enough vitamin D.
Give up smoking and reduce your weekly alcoholic drinks total and you’ll be well on your way to stronger bones.
PUMP SOME IRON
You don’t need to turn into a bodybuilder, start wearing a bikini and slap some scarily deep self-tan about your person…any resistance training will improve your bone density.
By resistance, we mean something that’s heavy for you, relative to your size and strength. Wafting around a small dumbbell won’t ward off osteoporosis. Lifting heavier weights won’t bulk you up either, they will just make you stronger.
It’s great if you are keen, but don’t just jump into the gym and try to bench press the equivalent of a small horse. Get some advice from an instructor or personal trainer.
Create a plan and stick to it. Consistency is key. Don’t overdo it though as crazily over-exercising will overstress your bones and not give your body time to repair and build up between sessions.
Speak to your doctor
Speak to your doctor and ask about HRT. There is lots of research that shows the beneficial effect of HRT on bone health, on reducing the number of broken bones and in preventing bone loss.
Women who have had an earlier menopause transition are at greater risk of osteoporosis. This is why women who have gone through menopause under the age of 40 (called POI – premature ovarian insufficiency) should discuss HRT with their doctor and why they should take HRT until the average age of the menopause of 51 yrs. Not taking HRT with a premature menopause can significantly increase your risk of osteoporosis and fractures.
FOR HINTS AND TIPS FOR THOSE WHO WANT TO SUPPORT SOMEONE THEY THINK MAY BE ENTERING OR IN MENOPAUSE
As this is often a silent symptom, it’s more about what you can do together to prevent osteoporosis. Strengthen your bones and your bond at the same time.
OUR ADVICE TO THEM
In terms of self-care, we’ve recommended that they keeps their BMI above 19, stop smoking and don't drink heavily if they want to avoid osteoporosis.
It’s also vital they know if anyone in their family has had frequent broken bones. Do they have a condition that makes it difficult for them to absorb calcium? Do any of their medications threaten their bone health?
CREATE A WEEKLY MEAL PLAN
It’s really important menopausal people ward off weak bones by getting enough vitamin D and calcium in their diet.
Plan meals ahead to get an overview of what you’re eating and manage both your weights too. Share the responsibility by shopping for ingredients together and sharing the cooking.
SUGGEST A SUPPLEMENT
If they are not getting enough calcium and vitamin D from their diet, perhaps supplements might help.
Why not gently ask if they have tried anything like that?
STUB OUT SMOKING
Did you know that if you decide to quit together you are almost six times more likely* to kick nicotine than going it alone? And they are far more likely to have healthy bones.
Help them say goodbye to cigarettes forever by ditching the smokes too. You can then keep each other going, avoid temptation and bash those cravings on the nose.
*Research by the Imperial College London
Regular weight training exercise is a keyway for them to maintain bone mass during the perimenopause and menopause.
Combining something you want to do (spend time together) along with something you both need to do (exercise for health) can be a real game changer.
Partnering up to go to the gym can help you both stay motivated. Perhaps you could book a joint personal training session or spot each other as you lift?
FIND A NEW FOCUS
We can’t wish symptoms away, but it sure helps if we can find something nice to distract ourselves from them for a while.
Give yourselves and your relationship a new lease of life by finding something new to do together. Take their lead, they may not be up for learning to jive, but she might always have wanted to learn photography or how to cook Thai food, for example.
If you’re worried about loss of bone density, you should see your GP who can discuss your symptoms in the context of the menopause.
If you'd like more information, we have put some further references below for you: