Women who have had menopause (postmenopausal) are at greater risk of developing osteoporosis, due to the reduced production of the female hormone estrogen.
Half of all women over the age of 60 years will have at least one fracture due to osteoporosis. If peak bone mass isn’t reached during adolescence or built up in the early adult years, then bones may be at a disadvantage during menopause when bone reduction is at its most rapid stage.
After optimal bone density is reached, most people from around 35 years onward, lose bone, on average at one per cent each year but for the first five years after menopause, women’s bone loss rate is double at about 10 per cent.
Reducing the osteoporosis risk will help especially if you:
Eat a calcium rich diet including low fat dairy foods such as milk, yoghurt and cheese. (Also see Nutrition)
Exercise regularly especially with weight bearing such as aerobics and resistance training which builds muscle and bone strength and assist in improve balance. (also see Exercise)
Take medication (bisphosphonates) as prescribed by your doctor to preserve your bone density
Have adequate calcium or supplements as recommended by your doctor
Take Hormone Replacement Therapy to put back lost estrogen caused by menopause
Get 20 minutes of sunshine (Vitamin D) every day
Take extra prescribed medication as recommended by your doctor (strontium ranelate, tibolone and parathyroid hormone when necessary)
Hormone Replacement Therapy (HRT) is the replacement of estrogen, in many cases estrogen plus progestogen, which has been used worldwide to relieve menopausal symptoms (vaginal dryness, hot flushes, night sweats). If taken when menopause begins research has shown it can reduce spinal fractures on average by 40 per cent.
But there have been at least 10 large studies on the long term effects of HRT in women (The US Women's Health Initiative study (USA)-2002 & 2003, the Million Women Study (UK) 2003 and the Women's International Study of Long Duration Oestrogen after Menopause (WISDOM) 2007 are the main ones) which have all found a small increased risk of breast cancer, coronary heart disease, stroke and clotting in lungs and legs.
The Australian Drug Evaluation Committee (ADEC) reviewed HRT research and recommends it shouldn’t be used as a preventative osteoporosis treatment and should only be considered for relief of severe hot flushing for short periods of time in light of the increased breast cancer risk. There are a few things to remember about HRT:
Bone loss will begin once HRT is stopped
If you do take it, have it reviewed every six months to a year with your specialist to make sure your dose is right for you and to consider other options if you need a break from taking it
Inform your doctor of any family history of cancer especially breast cancer and heart disease as there is an increased risk for those women who take HRT and have a family history of these diseases
Strontium ranelate is a natural trace element in soft tissue, blood, teeth and bone which scientists believe assists in a decreased bone loss rate and may even improve bone formation. Research has been promising with reduced fracture rates especially in the spine and hip. Your specialist may prescribe this granulated medication on a private script but it is expensive and isn’t listed for subsidy on the Pharmaceutical Benefits Scheme.
Parathyroid hormone injections increase bone renewal and calcium absorption from the stomach and kidney in postmenopausal women
Generally, calcium and vitamin D supplements should be taken daily with the injections to increase its efficiency There is some caution attached to Parathyroid hormone treatment as this is a very new drug with no long term side effects studied in humans yet.
In Australia it’s available only by prescription from an osteo specialist for a once only 18 month course. As its not listed on the PBS it’s availability is limited because of its expense.
Tibolone is an alternative hormone therapy for the relief of menopausal symptoms, which has shown increases the density of bone minerals but extensive clinical trial evaluation is still needed on its long-term effects.
Menopause Symptoms 
