We build our bones in our younger years, up to around age 30, at which point we generally reach a plateau, but in menopause women lose a lot of bone mass due to hormonal changes. After menopause the rate of bone loss decreases.
If we didn’t make enough bone in our younger years the risk of osteoporosis is higher.
Osteoporosis is a disease of the bones that causes the bone to lose mass and become weaker and easier to fracture.
A Bone Mineral Density (BMD) test can tell you whether or not you have osteoporosis and how likely you are to develop it in the future.
Who should have a BMD test? According to Osteoporosis Canada:
- All women and men 65 years or older
- Postmenopausal women and men 50 – 64 with risk factors for fracture including:
- Fragility fracture after age 40
- Vertebral fracture or low bone mass identified on x-ray
- Parental hip fracture
- High alcohol intake
- Current smoking
- Low body weight, i.e. less than 132 lbs or 60 kg
- Weight loss since age 25 greater than 10%
- High-risk medication use: prolonged glucocorticoid use, aromatase inhibitors for breast cancer, androgen deprivation therapy for prostate cancer
- Rheumatoid arthritis
- Other disorders that may contribute to bone loss
In BMD test results your bones are compared with the bones of an average young adult. A score (called a T-score) is calculated that describes the density of your bones (usually at the spine and hip) and tells you how strong your bones are compared with this average. While some bone loss with aging is normal, making such comparisons helps to determine whether you are losing bone more rapidly than expected for someone your age.
According to World Health Organization (WHO) classifications, “a T-score below 2.5 SDs indicates osteoporosis and a score between 1 and 2.5 SDs indicates osteopenia or low bone density. Normal bone density is no more than 1 SD below the young adult normal value”.
Besides being assessed by the health care provider for their risk of osteoporosis, women can also determine their fracture risk. Major risk factors for fractures from osteoporosis are:
- Advanced age
- Low BMD
- Previous fracture as an adult (other than skull, facial bone, ankle, finger, or toe)
- History of hip fracture in a parent
- Weight under 57.7Kg (127 pounds)
- Current smoking
- Not enough calcium and vitamin D in diet
- More than two alcoholic drinks per day
- Use of certain prescription medications (steroids) for longer than 3 months
- Increased risk of falls
The Fracture Risk Assessment tool (FRAX) calculates a woman’s 10-year probability of hip fracture or other major osteoporotic fracture (spine, forearm, upper arm). If you are over the age of 40 you can calculate your risk of fracture by visiting FRAX website.
Select the “Calculation Tool” and your geographic location and follow the directions.
Among the factors that increase a women’s risk of osteoporosis are heredity, smoking, lack of exercise, and certain medications (steroids).
There are also several things women can do to avoid osteoporosis and resulting fractures:
- Eat a balanced diet high in fruits and vegetables
- Get enough calcium
- Get enough Vitamin D
- Avoid alcohol and smoking
- Be physically active every day
- Reduce the risk of accidents. Use good lighting, use non-skid rugs on floors, use mats and bars in bathtubs and showers, remove obstructions to walking
- Certain medications can cause dizziness and loss of balance, and others loss of bone. Talk to your doctor or pharmacist about your medications
If you live in Ontario, you can call EatRightOntario, toll free, for more information on diet to help prevent osteoporosis 1-877-510-5102.
You can contact me to make an appointment and discuss your risk of osteoporosis and/or fractures related to menopause.