Every body reacts differently when it goes through menopause. But largely, the signs may be the same for all women. It is during this transition that she has to take care of and understand her body like never before, so as to prevent additional health issues.
The World Health Organization (WHO) defines menopause as ‘at least 12 consecutive months of amenorrhea (no menses), which is not due to any physiological and pathological causes’. The average age of menopause is 45 to 50 years. And with the life expectancy increased to more than 75 years, most women will spend more than one-third of their life beyond menopause, believes Dr Sonal Kumta, consultant, Obstetrics and Gynaecology, Fortis Hospital Mulund.
Menopause occurs due to depletion of eggs from the ovaries. This impacts the hormone estrogen, which is responsible for several short-term symptoms like hot flushes, night sweats, vaginal dryness, loss of interest in sex, mood swings and long-term consequences such as the increased risk of cardiac diseases and postmenopausal osteoporosis, the doctor explains.
While osteoporosis impacts 200 million women worldwide, it is a growing concern for society. By 70 years of age, 1 out of every 5 women will have osteoporosis.
What is it?
Osteoporosis is a skeletal disease which occurs because of weakening and loss of architecture of the bones. It leads to increased bone fragility and fracture risk. For women who are below 30, the amount of bone loss equals to new bone formation hence Bone Mineral Density (BMD) is restored.
In postmenopausal women, however, new bone formation is reduced due to lack of estrogen, causing weak, brittle, and porous bones; there is a notable decrease in BMD as well. Estrogen also plays an important role in increasing calcium absorption. Low calcium absorption can give rise to brittle bones. Common sites of osteoporotic fractures are the wrists, spine, and hip bone in elderly women. Often these fractures cause loss of mobility, poor quality of life and other complications like pneumonia, cardiac and thrombotic events leading eventually to death, warns Dr Kumta.
“It is a silent killer, as it may occur without any symptoms. It is important to keep it under check by undergoing a BMD test using DEXA scan or CT scan in all postmenopausal women; your gynecologist or your family physician can advise you regarding this test during your annual checkup. A ‘T’ Score between -1 and -2.5 indicates low bone mass while a ‘T’ score lesser than -2.5 indicates osteoporosis. It may cause bone aches, loss of height, back pains and a stooped posture,” she says, adding women are at a higher risk of developing osteoporosis than men.
“Osteoporosis is also hereditary. You have an increased chance of having it if parents or grandparents have had osteoporotic fractures. Women on medication like steroids or those with a history of cancer are at a higher risk, too.”
Prevention and treatment
The doctor says that women need to establish an exercise program that includes weight bearing exercises (where your muscles work against gravity) like walking, jogging, dancing, etc. Adequate sunlight exposure and consumption of foods rich in calcium — like dairy products, fish, green leafy vegetables, nuts etc. — can help. Limiting consumption of alcohol and avoiding smoking can also prove to be beneficial.
“There are several medications available which include calcium, vitamin-D, bisphosphonate, SERMS (Selective Estrogen Receptor Modulator), hormone replacement therapy, monoclonal antibody and newer bone-building medications, among others. It is best to consult your doctor before starting with treatment,” Dr Kumta concludes.
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