One of the concerns of menopause is the loss of bone density, or osteoporosis. The prevailing thought for many years was that women lose bone density at menopause when there is a change in estrogen levels. Low levels of estrogen were felt to be the cause of osteoporosis. Now the results of several studies are showing that estrogen is only part of the picture in regards to bone loss. However, it still needs to be of concern to women when they start to go through menopause. Let's discuss the role that hormones play in bone mass loss. Hormones appear to have an affect on calcium metabolism. The specific hormones are parathormone from the parathyroid gland, calcitonin from the thyroid gland and vitamin D from the skin. Yes, a vitamin is a hormone - this is because it is produced by one organ and then travels through the blood to different organs - the definition of a hormone. Vitamin D helps you absorb greater amounts of calcium, so it is very important in the process because higher levels of calcium in the bloodstream can actually increase bone loss. And too much vitamin D can also leach calcium from your bones and increase bone loss. Estrogen has less of a direct effect on bone. It does block the bone-resorbing effect of parathormone and also stimulates the release of calcitonin and vitamin D. Progesterone has been shown to possibly block the effect of the adrenal hormones, which can increase bone loss. What does this mean to the menopausal woman? The first thing you should do in assess your risk factors. The risk factors for low bone density are thinness, caucasian ancestry, small framed, heavy alcohol use, advanced age, cigarette smoking, family history, inactive lifestyle, early menopause, use of corticosteroids and anticonvulsants, amenorrhea, low calcium diet and eating disorders. However - low bone density does not automatically mean that your bones will fracture. Obviously, low bone density is something you need to monitor and treat if necessary, but fractures, especially the hips and spine are a higher level concern. The risk factors for for fractures that you should be concerned with are a current weight that is less than it was at age 25, having a rapid heartbeat at rest of 80 bpm or more, a maternal history of hip fracture before the age of 80, a previous fracture after age fifty, if you are tall at age 25, if your health is fair or poor, previous hyperthyroidism, poor contrast sensitivity, poor depth perception, current use of long-acting benzos, current use of anti-convulsants, the inability to rise from a chair without using both arms, spending less then 4 hours a day on your feet and high doses of caffeine. The only way to tell if you have osteoporosis is by a bone-density screening. Osteoporosis is not painful until you suffer a fracture. Depending on your risk factors you may want to take calcium and vitamin D supplements. Exercise can also help. There are drugs like Fosamax, Raloxifene and Evista that can be used as an alternate for HRT and other drugs like Arimidex and Femara that are proving to be effective. In the future there may be drugs that help re-grow bone loss, so make sure your doctors are up on the current research. With a little prevention, osteoporosis and fractures can be dealt with easily before they become a problem. |
