The Link Between Menopause and Osteoporosis

If you’ve ever seen a human skeleton, you might think that your bones look like the ones you saw hanging before you: hard and brittle. But young, healthy bones aren’t brittle like sticks. They’re spongier, more flexible, and very much alive.

At Rheumatology Center of New Jersey, our expert rheumatologists know how important bone health is to overall health. Healthy bones and muscles allow you to enjoy the next phase of your life with minimal risk of injury or bone fractures.

But if you’re in perimenopause or menopause, you could already be losing precious bone mass. Unchecked, this bone loss could lead to osteopenia or even osteoporosis, which drastically increases your risk for fractures, including potentially life-threatening hip fractures.

Roughly 8 million women in the United States have osteoporosis. Osteoporosis is a condition in which your bones become porous and brittle instead of dense and resilient. Here’s what you need to know to keep your bones safe and strong.

Estrogen builds bones 

Estrogen is a family of steroid hormones that gave you your female sex characteristics during puberty, such as breasts. Estrogen also regulates the building and shedding of your uterine lining during menstruation. 

Estrogen is instrumental in building and maintaining bone density. The hormone works in partnership with vitamin D, calcium, and other nutrients to break down tired old bone cells and replace them with fresh, strong, new ones.

But when you enter perimenopause, your estrogen levels start to decline. Many of the symptoms you associate with menopause — including hot flashes, thinning skin, and a dry vagina — are due to a lack of this essential hormone.

Porous bones collapse

When your bones are young and healthy and have the hormones and nutrients they need, they continually turn over old bone cells. But as you lose estrogen, this renewal process slows down.

Instead, the old bone cells remain in place, without sufficient new ones to take their place. Instead of spongy, vibrant, densely compacted tissue inside your bones, you end up with porous bones that have large spaces between the bone cells.

Porous bones are brittle and subject to breakage. That's why older women (and men, too) sometimes lose height as they age. The vertebrae in their backbones are so brittle that the normal movements of life can cause compression fractures.

Compression fractures weaken the vertebrae so that they can’t maintain their height. The vertebrae collapse, which is why you may develop a curved or hunched spine and lose many inches of height over the years.

Porous bones break

Bones that aren’t being stimulated by estrogen are prone to other types of fractures, too. Women with osteoporosis are more likely to suffer fractures of their:

Hip fractures are particularly dangerous and may lead to an increased risk for early death if not treated in time.

You can help your bones

To find out how much, if any, bone you’ve lost, we may recommend a bone density scan. Based on your results, we devise a treatment plan. 

If you haven’t suffered menopause symptoms, you may be reluctant to use bioidentical hormone therapy (BHRT) to restore your estrogen and other hormones and preserve your bones. But BHRT and thyroid hormone supplements can help you build or maintain bone mass. 

Other medications help you maintain your current bone density or even build new bone cells. Depending on your circumstances, we may also recommend:

To find out if you have osteoporosis or its precursor condition, osteopenia, call our nearest location or request an appointment using our online tool. We offer bone-density evaluations at our offices in Somerville, Flemington, and Monroe, New Jersey. Telemedicine is also available.

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