Every woman goes through menopause. When it happens depends on the womans medical condition and lifestyle changes. According to a survey conducted a few years before by the Indian Menopause Society, the average age of menopause of an Indian woman is 46.2 years much less than their Western counterparts (51 years). There was a correlation between the age of menopause and social and economic status, married status, and parity status.

Women who have early menopause have 56 per cent increased risk of osteoporosis in their 70s according to a study held by Oxford Universitys publication Human Reproduction. The study claims that women who undergo premature menopause are almost three times more likely to develop osteoporosis as also other multiple, chronic medical problems including diabetes, high blood pressure, heart disease, stroke, arthritis, asthma, depression, anxiety or breast cancer.

Understanding The Causes

Dr Meenakshi Banerjee, Senior Consultant, Obstetrics and Gynaecology, Madhukar Rainbow Childrens Hospital, Delhi, gives her insight into this. It has been observed that during the menopausal transition period (perimenopause), the average reduction in bone mineral density (BMD) is about 10 per cent. About 25 per cent of post-menopausal women can be classified as fast bone losers, and this can be increased by various other factors like genetic influence, medicine effects like steroids, anti-estrogen medications, low exercise and activity among others.

Her colleague, Dr Neha Khandelwal, Senior Consultant, Obstetrics and Gynaecology, notes that there are various reasons of early menopause which can be genetic, Even premature ovarian failure, in which ovaries which are responsible for producing female hormones fails to produce adequate hormones, leads to early menopause. Removal of ovaries due to any pathology, malignancy can cause early menopause.

Osteoporosis is also termed as a silent disease as its effects are not seen in the early stages. Women are four times more affected by early bone loss as compared to men. Estrogen, which is a primarily female hormone, is responsible for bone health. After menopause and in the peri-menopause there is an increased bone loss due to decreasing estrogen levels hence making the women more prone for osteoporosis, adds Dr Banerjee.

The other factors affecting estrogen levels can also be related to women being on antiestrogen medications (given in breast cancer treatment), women who are on steroid medications for more than three months.

Preventive And Curative Solutions

A womans susceptibility to osteoporosis increases with reduced exercise, activity, low BMI and increased smoking and alcohol. Over time, the bones become weak because of poor lifestyle choices such as smoking, drinking alcohol or eating junk food. Adopting a healthy lifestyle coupled with adding fresh fruit and herbs in your daily diet can help to overcome the disorder, the good doctors both feel.

Walking and gentle aerobics are excellent for bone health because they promote the entry of calcium into the bone mass where it is used for improved strength and growth. A healthy and balanced diet is fundamental to bone (and general) health because it supplies the protein, carbohydrate and fat, vitamins, minerals and other nutrients vital for tissue renewal and growth, advises Dr Banerjee.

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Fresh fruit and vegetables supply a vast range of essential minerals and other nutrients needed to maintain a sturdy skeleton. Your diet should also include dairy foods and foods rich in calcium, like green leafy vegetables, spring greens, spinach and broccoli, baked beans, nuts (almonds), soya beans, sardines, salmon, nuts, dried beans, and sunflower seeds.

Vitamin D is also essential because it enables calcium and phosphorus to be used to form strong bones and teeth. It can be obtained from early-morning sunshine and as a supplement. Such patients should expose their body to sunlight for 20 minutes/day from May to October. It can also be obtained from food, e.g. milk and dairy products, fish liver oils, sardines, herring, salmon, and tuna.

There is something that can help to reduce the loss of bone and other postmenopausal symptoms like vaginal dryness and hot flushes. Hormone replacement therapy in the form of estrogen is a what can be undertaken to overcome the problem, but like any other therapy, the woman needs to take utmost caution and proper screening should be done beforehand to analyse how the therapy can work for her.

Dr Khandelwal shares, Hormonal therapy can be taken in the form of tablets, skin patches, estrogen gel and implants. Cyclical HRT can be taken with daily estrogen and progesterone alongside for the last 14 days of the cycle. This is for women with menopausal symptoms. For post-menopausal women, continuous combined HRT should be considered without breaks.

Also Read: 4 Reasons For An Early Menopause

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Early Menopause And Osteoporosis: Know The Risks - Femina