As you enter menopause, are your bones in good condition?

This is the 4280th article of Da Yi Xiao Hu

When entering menopause, many women tend to be more anxious about whether their appearance will age, and rarely pay attention to whether their bones will age. In fact, osteoporosis is quietly occurring during menopause, and bones will slowly be lost if you are not careful. Some women will experience back pain, stiff joints, hunchbacks, etc. In severe cases, they may even suffer fractures before they realize that it is osteoporosis.

Fluctuations in bone mass in women throughout their life

Regardless of whether it is male or female, the bone mass in the human body is not static, but changes with age. Before the age of 20, the bone mass is in an increasing period to meet the growth and development of adolescents. The bone growth and development reaches its peak from 20 to 40 years old, which is also the peak period of bone mass. After the age of 40, with the increase of age, bone mass begins to be lost. The bone mass of women after menopause can drop drastically.

Why are women more prone to osteoporosis during menopause?

Estrogen is an important element in maintaining female bone health and regulates the balance of bone metabolism. Osteoblasts (bone formation function) and osteoclasts (bone resorption function) are the other two key foundations for maintaining bone dynamic balance. Normal estrogen secretion can promote osteoblast proliferation and differentiation, induce osteoclast apoptosis, and inhibit activity, thereby maintaining the balance between bone resorption and bone formation and protecting bone tissue. However, the estrogen level of menopausal women decreases progressively or precipitously, which weakens the inhibitory effect on osteoclasts and increases osteoclast activity, leading to reduced bone density, changes in bone microstructure, reduced bone strength, and even brittle fractures.

How to prevent osteoporosis during menopause?

1. Adjustment of dietary structure

Pay attention to a balanced diet and increase the intake of foods high in calcium and vitamin D as appropriate, such as: calcium-fortified milk, eggs, fish, animal liver, lean meat, green leafy vegetables, mushrooms, etc.

2. Increase in outdoor activities

Regular outdoor physical exercise can promote blood circulation and enhance bone nutrition; sufficient sunshine can help vitamin D promote the intestinal absorption and conversion of calcium.

3. Appropriate calcium supplementation

Under the guidance of a doctor, you can take calcium carbonate, calcium citrate and other drugs to supplement calcium.

4. Vitamin D supplementation

When blood tests for serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D indicate vitamin D deficiency or insufficiency, vitamin D can be supplemented appropriately. Younger women in good physical condition can supplement with ordinary vitamin D, while older people with poor liver and kidney function can choose active vitamin D.

5. Estrogen supplementation

Younger women who are estrogen deficient and women with menopausal symptoms can take appropriate estrogen supplements to prevent postmenopausal osteoporosis; women with high-risk factors for osteoporosis or women with postmenopausal osteoporosis can take appropriate estrogen supplements to improve osteoporosis; of course, before estrogen supplementation, a professional physician must assess the woman's overall health condition, rule out drug contraindications, and use it strictly under the guidance of a physician, and do not supplement privately.

Author: Department of Gynecology, Huadong Hospital, Fudan University

Zhu LihongDeputy Chief Physician