Osteoporosis, often seen in post-menopausal women, is a disease in which your bones lose density and become porous, weak, and brittle. It has few outward symptoms, and is often not diagnosed until you experience a bone break or fracture from a fall or other accident. If the mineral loss is severe enough, a fracture can occur even without external trauma. One osteoporosis-related injury leaves you more vulnerable to further injuries. Fortunately, there are steps you can take to strengthen your bones and prevent a first injury from occurring. 

Osteoporosis and Menopause

Estrogen naturally protects your bones by slowing the rate of bone loss. As you enter perimenopause, the months and years of hormonal changes leading up to menopause, your estrogen and progesterone levels start to decline. The lower estrogen levels, particularly postmenopause, means that your bones are losing more tissue than they’re making. This can lead to osteoporosis. 

Other Risk Factors for Osteoporosis

Lower estrogen levels aren’t the only cause for osteoporosis, however. Other factors can weaken bones, and when those factors are combined with reduced estrogen levels, the combination can initiate osteoporosis or hasten its progression if you already have it. 

Other risk factors for weakened, brittle bones include:

• Age. Before age 30, your body generates more bone than you lose. After 30, bone deterioration occurs more rapidly than its creation. Women over 50 are at greatest risk.
• Smoking. Smoking can increase your risk for osteoporosis. It has also been linked to early menopause. People who smoke are also slower to heal than nonsmokers after a bone fracture. 
• Body composition. Thin and/or petite women have less bone mass overall, so are at higher risk of developing osteoporosis than heavier or larger-framed women. This is also true for men. 
• Existing bone density. The greater your bone density when you reach menopause, the lower your chances of developing osteoporosis.
• Family history. Having a parent or grandparent with osteoporosis increases your risk of developing it later in life.
• Gender. Women are up to four times more likely to develop osteoporosis than men. This is because women tend to be smaller and usually weigh less than men.
• Race and ethnicity. Risk of osteoporosis-related fractures is highest in northern European and Causasian women worldwide, but Asian, Native American, Hispanic, and Black women are not far behind. 

What Can Help Prevent Osteoporosis?

A variety of can help prevent, slow, or stop the development of osteoporosis. Here are some ways to prevent bone deterioration.

Vitamins and Minerals

Calcium. Calcium can help maintain strong bones as you age. The National Institutes of Health (NIH) recommends 1,000 mg daily for people aged 19 to 50, and at least 1,200 mg for women over 50 and all adults over 70. Kale, broccoli, and dairy products are good sources of calcium.

Vitamin D. Your body can’t properly absorb calcium without an adequate amount of vitamin D. Sun exposure is one of the most natural ways to signal your body to make vitamin D, but it can be difficult to get enough that way. You can also get vitamin D from eating salmon and mackerel, and D-fortified milks and cereals. You can also take supplements. The NIH recommends that people over 70 increase their daily vitamin D intake from 600 to 800 IUs, but ask your doctor how much D is both necessary and safe for you. 

Medications

Bisphosphonates. This group of drugs helps prevent and slow bone loss, increase bone density, and lower the risk of fractures. In one study, bisphosphonates reduced the rate of osteoporosis-related fractures by up to 60%. They are the most common osteoporosis drugs.

Monoclonal antibodies. Drugs such as denosumab and romosozumab can also be used to help prevent osteoporosis by inhibiting bone resorption and slowing bone erosion. 

Selective estrogen receptor modulators (SERMs).  SERMs are drugs with estrogen-like properties. One study found that SERMs reduced the risk of spine fractures by up to 42%.

Weight-Bearing Exercise 

Any form of exercise, whether swimming or gardening, supports your overall health, but weight-bearing exercises are particularly good for strengthening your bones. Strong bones mean both lower risk of fractures and faster recovery when injuries do occur. Examples of weight-bearing exercise include not only formal weight-lifting, but also:

• Walking, 
• Jogging, 
• Dancing, and 
• Aerobics.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) can help prevent menopause-related bone loss, and relieve other symptoms such as hot flashes, night sweats, and mood swings. The treatment does come with risks, however, and experts recommend not using HRT if you have a history of, or are already at risk for blood clots, breast cancer, heart attack, or stroke, as well as several other medical conditions. Physicians usually suggest trying non-hormonal therapies first. Speak with your doctor about the benefits and risks of hormonal options for your specific situation.

*Holland, K. (2019, Aug. 2). Osteoporosis, Bone Health, and Menopause. Healthline. https://www.healthline.com/health/menopause/osteoporosis