Why does the risk of osteoporosis increase at menopause?

Bone is estrogen dependent, and many women will experience a more rapid decrease in bone density in the first several years after menopause. Bone is very metabolically active tissue. Cells called “osteoclasts” destroy old bone, and “osteoblasts” lay down new bone. From the ages of 25-30, women achieve their peak bone density. The osteoblasts are much more active than the osteoclasts in our youth. After menopause, if estrogen is not replaced, the ratio of osteoclastic activity surpasses that of osteoblastic activity, resulting in bone loss. The rapid change is more pronounced initially, then tends to slow down. The biggest risk factor for osteoporosis is family history. It makes sense, height and bone structure are largely inherited. Many women try their best to prevent osteoporosis, exercising vigorously, and taking calcium and Vitamin D, just to find that they still experience bone loss. Fractures of the hip and spine are a significant cause of morbidity and mortality in the elderly, so medication may be warranted.

Fifty percent of women will experience an osteoporotic fracture in their lifetime. Of the women who experience a hip fracture, only 40% will ever achieve their pre-fracture independence. This is a huge problem that should be addressed and treated as a normal part of preventive care. More to come.....