Why Osteoporosis is More Common in Women

Osteoporosis is a disease that weakens bones, increasing the risk of unforeseen fractures. Literally indicating ‘porous bone’, osteoporosis results in an increased loss of both bone mass and strength. The disease may progress without any pain or symptoms – this is why it is often referred to as a ‘silent disease’.

Although it is not fair, it is true: If you are a woman, you are automatically at greater risk for osteoporosis than men. Worldwide it is estimated that an osteoporotic fracture occurs every three seconds. One in three women and one in five men at the age of 50 suffers a fracture in their remaining lifetimes. In women particularly over 45 years of age, fractures resulting from osteoporosis can result in more number of days spent in a hospital compared to many other diseases, including diabetes and heart attacks.

There are several reasons why women are more prone to suffering from osteoporosis than men, including the following:

• Women have smaller and thinner bones compared to men
• Oestrogen, a hormone in women which protects bones, starts decreasing rapidly with the onset of menopause, causing bone loss.

Osteoporosis and young adult women

Although osteoporosis is most common in older people, it affects young people, including women who are in their 20s, 30s, and 40s. The term ‘premenopausal’ refers to women still having menstrual periods. While it is not very common for premenopausal women to suffer from osteoporosis, some women have low bone density that increases the chance of suffering from osteoporosis later during their lifetime.

Young women with a low bone density, caused by low peak bone mass, are at an increased risk of getting osteoporosis later in life. Often, when premenopausal women suffer from osteoporosis, it may be due to prolonged consumption of a medicine or underlying medical condition causing bone loss.

Osteoporosis caused by a medicine or medical condition is known as secondary osteoporosis. Premenopausal women sometimes suffer from osteoporosis for no specific reason. Such a type is called idiopathic osteoporosis where ‘idiopathic’ indicates that the cause of osteoporosis is inexplicable.

Osteoporosis and menopause

Postmenopausal women are at the greatest risk of suffering from osteoporosis and fractures due to rapid bone loss occurring with the onset of menopause. Bone mass peaks in the mid-twenties and remains more or less stable until the beginning of menopause, occurring in women between the ages 50 and 53 years in North America and Europe, and as early as age 42 in Asia and Latin America.

Oestrogen is the hormone that regulates a woman’s reproductive cycle. It also plays an essential role in keeping bones strong and healthy, in both women and men. While premenopausal women usually have more oestrogen than men, they are likely to experience dramatic drops in oestrogen production with the onset of menopause and tend to experience bone loss and osteoporosis.

Women are at an increased osteoporosis risk related to oestrogen levels if they:

• Experience irregular periods or started having periods at a later than normal age
• Are cancer patients
• Have had their ovaries surgically removed
• Are going through menopause (those undergoing menopause at an early age are at greater risk)

Women end up losing bone mass more quickly over the years immediately after menopause begins than they do at any other time during their lives.

Besides oestrogen deficiency, reduced intestinal calcium absorption, increases in urinary calcium losses, and loss of bone protective hormones affect bone health.

On the other hand, studies show that women with a higher level of oestrogen than their peers, such as women whose menstrual cycles began earlier than normal or those who consumed contraceptives containing oestrogen tend to have a higher bone density.

Essential Strategies to reduce osteoporosis

The risk of developing osteoporosis and fragility fractures is determined by many factors, some of which can be altered (e.g. nutrition, exercise, and smoking) while others cannot (e.g. age at menopause, family history, and diseases).

While peak bone mass is genetically determined, after the age of 65 genetics plays a diminishing role in bone loss and other factors like exercise and nutrition play a crucial role. Maintaining a healthy skeleton revolves around the following strategies to reduce the risk of fractures and osteoporosis:

1. Exercise regularly

The saying ‘move it or lose it’ is never truer than after the age of 50. At menopause, exercise becomes imperative for the maintenance of both muscle strength and bone mass.

Besides maintaining bone strength, the goal is to increase muscle mass to improve muscle function, and maintain strength and balance. Weaker muscles and poor balance contribute to more frequent falls and fractures.

Exercise for women with osteoporosis

If you have osteoporosis, your exercise programme should target balance, posture, coordination, gait, and hip and trunk stabilization. An individually targeted and supervised exercise programmes can aid recovery, prevent injurious falls, and improve the overall quality of life.

Exercises for postmenopausal women who are not suffering from osteoporosis

Overall, you must aim to exercise for about 30 to 40 minutes, at least thrice a week with some resistance and weight-bearing exercises under supervision.

2.  Identify your risk factors

To enable you and your doctor to identify whether you may be at high risk of suffering osteoporotic fractures, you should be aware of the following ‘non modifiable’ risk factors:

• Previous fragility fractures
• Family history of osteoporosis and fractures
• Early menopause
• Rheumatoid arthritis
• Diseases of malabsorption

3. Talk to your doctor

Menopause is the time to take action for a break free future – and that means consulting your doctor regarding your bone health. If you are encountering any risk factor, it’s important to ask your doctor for an examination which is likely to include an assessment of future fracture and bone density measurement. If you are at risk of falls, discuss fall-prevention strategies.

Depending on the results of the clinical assessment, your orthopaedic will make specific recommendations. Irrespective of risks and the treatment is prescribed, proper nutrition and an active lifestyle are essential to optimizing both your musculoskeletal and general health – and this is more important at menopause than ever before!

4.  Avoid negative habits

Negative habits affect general health and also have a negative impact on the bone health, raising the risk of fractures and osteoporosis.

• Smoking

Smokers and those who used to smoke in the past are at an increased risk of any fracture compared to non-smokers.

• Excessive alcohol intake

Alcohol consumed moderately may not negatively impact your bone health. But long-term alcohol consumption significantly increases fracture risk in both women and men, affecting bone-forming cells and hormones and increasing risk of falls.

• Maintaining a healthy weight

Being underweight is associated with increased bone loss and risk of fracture. For instance, individuals with a BMI of 20 kg/m2 will have a two-fold increased risk of fracture compared to those with a BMI of 25 kg/m2. Hence, it is imperative to ensure that the meals provide the necessary nutrients and enough caloric intake to maintain healthy muscles and bones.

For further details, request an appointment with an orthopaedic doctors.