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How will your bones handle menopause?

Throughout life our bones provide the framework that allows us to sit, stand and move. To stay healthy and strong, they must be fed well and exercised often.

But even after a lifetime of good treatment, some women's bones weaken quickly around the time of menopause.

If ignored, this weakening could progress to osteoporosis, sometimes called brittle bone disease.

For the best chance at keeping their bones healthy, women should know how menopause can affect their bones and what they can do to keep their bones in shape.

A bone's life

Our bones change constantly through a process called remodeling. It's kind of like remodeling a house—old structures are torn down and new structures are built to replace them.

Over the first 30 or so years of life, more bone tissue is built than torn down. After that, more bone is torn down than built. For most people this is a slow, gradual process that doesn't cause problems. But when other factors, such as high or low levels of some hormones, poor health, inactivity or poor diet intervene, bone loss can become rapid and problematic. For many women, rapid bone loss is due to low hormone levels after menopause.

Menopause and bones

Most women undergo menopause somewhere between ages 45 and 55. During this time, the ovaries start producing fewer hormones. When menopause is complete, a woman's periods stop and her ovaries produce very little of the hormones estrogen and progesterone.

In some women this drop in hormone production leads to serious bone problems. Estrogen helps bones absorb and conserve calcium, explains the National Institute on Aging. When estrogen levels drop, bones can start losing strength quickly.

A prescription for stronger bones

For a long time, women and their doctors turned to hormone therapy to keep bones strong after menopause. Hormone therapy reduces bone loss, increases bone density and reduces the risk of broken bones in the spine and hip.

But large studies have shown that hormone therapy can also slightly increase risks for heart attack, stroke and breast cancer. Because of these risks, women may want to consider other medications.

Some medicines approved to prevent or treat osteoporosis include calcitonin, raloxifene, bisphosphonates, denosumab and parathyroid hormone. Your doctor can recommend the treatment that's best suited to you.

Bone-building choices

The way you live affects your bones too. According to the National Osteoporosis Foundation, these healthy choices should be a part of every woman's osteoporosis prevention plan:

  • If you're 50 years old or younger, consume at least 1,000 milligrams (mg) of calcium every day. At age 51, increase your intake to 1,200 mg a day.
  • If you're younger than age 50, you need 400 to 800 international units (IU) of vitamin D daily. If you're 50 or older, consume 800 to 1,000 IU every day. (Vitamin D has an important role in calcium absorption.)
  • Take time for regular weight-bearing exercise such as walking, jogging or aerobics.
  • Remember that smoking or drinking alcohol can weaken your bones.

Keeping tabs

Generally, women should start regular screening for osteoporosis at age 65, according to the U.S. Preventive Services Task Force. Women at increased risk for osteoporotic fractures because of family history or personal risk factors, such as smoking, inactivity or a small frame, should start screening at an earlier age.

The recommended screening test is a painless and noninvasive imaging test called dual-energy x-ray absorptiometry, or DXA.

As you approach menopause, make a doctor's appointment to check in on your risk for osteoporosis as well as for other health problems that become more common with age. Prevention, as always, is the best medicine.

reviewed 5/12/2016

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