World Health Day: Women Experience Rapid Bone Loss After Menopause, Osteopenia Develops ‘Silently’, Experts Say

World Health Day 2023: Some of the common bone health problems women suffer from are osteopenia, osteoporosis, postmenopausal osteoporosis, bone cancer and bone infection.

World Health Day 2023: Women have become more aware of the importance of their bone health over the years. Women are prone to faster muscle loss compared to men because of inefficient calcium deposition following muscle stress. Also, women age faster, as a result of which they experience a higher and faster reduction in bone density, compared to men.

Postmenopausal women suffer from a lot of bone health problems. Women experience rapid bone loss in the first ten years after menopause, according to experts.

Bone health problems women suffer from

Some of the common bone health problems women suffer from are osteopenia, osteoporosis, postmenopausal osteoporosis, bone cancer and bone infection.

Osteopenia

Osteopenia is a medical condition characterised by a decrease in bone mineral density below normal reference values, but not low enough to meet the diagnostic criteria to be considered osteoporotic, and is more common in people older than 50 years of age, especially women. Osteopenia weakens women's bones, but not to the point where the bones break easily. 

According to experts, osteopenia develops “silently”.

“Postmenopausal osteoporosis is a common problem among women. Osteopenia develops silently as women grow older. It happens when the bone mineral density gets lower,” Dr. Manju Wali, Senior Consultant – Obstetrics And Gynaecology, Max Super Speciality Hospital, Patparganj, told ABP Live.

Osteoporosis

However, osteoporosis is the more serious progression of osteopenia, wherein loss of bone mineral density weakens the bones to the point where they could fracture or break easily. 

Osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease, or when the quality or structure of the bones changes, leading to a decrease in bone strength. This can increase the risk of fractures or broken bones. 

According to the NIH, osteoporosis is a "silent" disease because one typically does not have symptoms, and may not even know they have the disease until they break a bone. Bones can weaken at an earlier age in women than in men, according to experts. 

According to the United States' National Institutes of Health (NIH), the prevalence of osteoporosis is four times more common in women than in men.

“Usually, women are more at risk of developing osteoporosis than men because the hormonal changes that happen after menopause directly affect bone density. The female hormone oestrogen is essential for healthy bones,” Dr. Akta Bajaj, Senior Consultant and Head – Obstetrics & Gynaecology, Ujala Cygnus Group of Hospitals, told ABP Live.

When a woman has osteopenia, her bone density score is between -1 and -2.5. A woman with osteoporosis has a bone density score of -2.5 or less, according to Johns Hopkins Medicine.

Sometimes, the side effects of some medicines, such as steroids and breast cancer therapies can lead to bone damage and osteoporosis.

“Osteoporosis and bone damage from some medicines' side effects are possible. Steroids, breast cancer therapies, and epilepsy control drugs are a few of these. The impact of your medicines on your bones should be discussed with your doctor or pharmacist,”  Dr Rashmi Baliyan, Consultant – Obstetrics & Gynaecology, Primus Super Speciality Hospital, told ABP Live.

Oestrogen is a female sex hormone that prevents excessive bone loss.

Postmenopausal osteoporosis

Postmenopausal osteoporosis is the most common type of osteoporosis, according to a study published in the journal Nature Reviews Disease Primers. Postmenopausal osteoporosis occurs due to oestrogen deficiency, which results in an increase in bone turnover. 

Bone turnover is the process of resorption, or bone breakdown leading to the release of minerals and transfer of calcium from bone fluid to the blood, followed by replacement by new bone with little change in shape. 

“The chance of developing osteoporosis is highest in postmenopausal or older women. Since menopause inhibits the production of oestrogen, a hormone that prevents excessive bone loss, women experience rapid bone loss in the first ten years after menopause,” Dr Bhaliyan said.

Oestrogen deficiency affects all types of bone cells. Due to the imbalance in bone formation and resorption, trabecular bone, or a porous bone composed of hard and soft tissue, and cortical bone, which is the connective tissue organised as regular sheets of tissue on the outer layer of long bones, and forms a protective layer around the internal cavity, are affected. 

In women with postmenopausal osteoporosis, there is loss of connectivity in the trabecular bones, and cortical thinning and porosity of the cortical bone. 

On average, up to 50 per cent of women above 50 years of age are at risk of fractures. 

Osteoporosis can be diagnosed with the help of bone density measurements of the lumbar spine, which consists of the five vertebrae in the lower back, and proximal femur, or the upper end of the femur. 

Bone infection or osteomyelitis

Osteomyelitis is an infection which can reach a bone by travelling through the bloodstream or spreading from nearby tissue, or can begin in the bone itself if an injury exposes the bone to germs. 

The symptoms of osteomyelitis include fever, pain in the area of infection, swelling, warmth and redness over the area of infection, and fatigue. 

People who smoke and have chronic health conditions such as diabetes or kidney failure are at higher risk of developing osteomyelitis.

Bone cancer

While bone cancer can begin in any bone in the body, it most commonly affects the pelvis or the long bones in the arms and legs. Bone cancer accounts for less than one per cent of all cancers. 

Bone cancer is more common in males than in females, according to the American Cancer Society.

How women can improve their bone health and avoid bone diseases

It is important for women to start taking care of their bone health between 20 to 30 years of age. Women can improve their bone health by consuming a healthy diet, exercising, and abstaining from smoking. High-risk populations can prevent fractures by reducing falls.

A healthy diet to improve bone health must include calcium-rich foods such as dairy products, almonds, kale, broccoli, and sardines, among others.

“Women can take care of their bone health by including plenty of calcium in their diet. Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines, and soy products, such as tofu,” Dr Bajaj said.

Also, women can reduce fracture risk by consuming licensed drugs that slow down bone resorption or stimulate bone formation. Bisphosphonates and denosumab are licensed drugs that slow down bone resorption, and teriparatide is a drug that stimulates bone formation.

Taking calcium and Vitamin D3 supplements can also improve women’s bone health.

“Women can take care of their bone health through supplementation of calcium and Vitamin D3 and by scheduling a bone density scan. Women should pay attention to their bone health especially after 35 years of age,” Dr. Indrani Salunkhe, Gynaecologist, Wockhardt Hospitals, Mumbai Central, told ABP Live.

She recommended that women perform low-impact aerobics and climb stairs to improve their bone health.

Walking, dancing, and exercises involving weight bearing and resistance can help improve women’s bone health.

“Exercise, vitamin and mineral supplements, and medicines are all possible treatments for osteoporosis that has already progressed. You may benefit from taking supplements and engaging in physical activity to avoid osteoporosis. Exercises involving weight bearing, resistance, and equilibrium are all crucial,” Dr Bhaliyan said.

Thus, all women should prioritise their bone health and take care of it from a young age, in order to prevent bone health problems in the future.