Premature Menopause and Bone Health
Usually, we only think about our bones when we break one!
Let’s try to be more proactive rather than reactive about our bone health.
This blog is for women who have found that they arrived at the menopause party early – meaning before the age of 40. This is often referred to as premature menopause. Early menopause can be due to one’s genetic make-up, an illness, or medical procedure such as a hysterectomy, or due to medication such as chemotherapy or other estrogen stripping medications.
For women who have experienced premature menopause, there is some new information that you would want to familiarize yourself with so that you can chat with your menopause specialist as to how this information impacts your individual health needs.
If you don’t have a menopause specialist, please find one. I have some great tips in my free eBook, MENOPAUSE MONDAYS The Girlfriend’s Guide to Surviving and Thriving During Perimenopause and Menopause in Chapter 13 or in this helpful post.
Women who experience an early menopause should speak to their menopause specialist about having a bone density test and discuss the pros and cons of estrogen therapy.
We have always known that if you entered menopause early, you may have a higher risk of fracture. However, a study evaluating the Women’s Health Initiative (WHI) data found out that even with calcium and vitamin D supplementation, the risk of fracture is still higher.
They studied 22,000 women who were in menopause before the age of 40. These women had significantly higher risks for fracture than women who experienced menopause between the ages of 40 and 49 or after age 50, regardless of treatment.
This can be quite disconcerting for many women. However, the study did tell us that women with early menopause are candidates for hormone therapy until at least the average age of menopause (52 years old) to reduce the risks of heart disease, osteoporosis, and cognitive and mood swings.
I reached out to Dr. Diane Schneider, the author of The Complete Book of Bone Health and founder of 4BoneHealth.org for her take on this study. Dr. Scheinder responded, “These results are not surprising. A relationship between menopause and skeletal health has been recognized for over 75 years since Professor Fuller Albright’s description of the negative impact of estrogen deficiency on skeletal health in 1941. Lack of estrogen is the main driver of bone loss so calcium and vitamin D did not appear to make an impact.
Early menopause, whether natural or surgical, is associated with lower bone density throughout the skeleton at a later age. However, oophorectomy leads to a more rapid bone loss than natural menopause. The earlier age of menopause, the lower bone density is predicted later in life. Evidence shows that early menopause is also associated with a higher risk osteoporotic fractures, particularly before age 70 years and that estrogen therapy is associated with fewer fractures. Whether early menopause continues to contribute to fractures after age 70 years is not yet known. Age-related changes in bone mass may be the main contributor to bone loss at older ages.”
The study suggests that early intervention and treatment with calcium, vitamin D, or hormones with appropriate dosing for young women, longer duration of treatment, and follow-up could provide better bone protection and ultimately reduce fracture risk.
“This study highlights the need for healthcare providers to take into consideration a woman’s age at menopause onset when evaluating patients for fracture risk,” says Dr. JoAnn Pinkerton, NAMS executive director. “Women at risk for bone loss need 1,200 mg of calcium per day, with adequate vitamin D, and encouraged to get as much as possible through diet due to concern that too much supplemental calcium may increase atherosclerotic plaque in women. Women with early menopause should discuss whether they are candidates for hormone therapy with their providers, an appropriate amount of calcium, vitamin D, and hormones.”
The study is being published online in Menopause, the journal of The North American Menopause Society (NAMS).
So, if you or someone you love has experienced, “early menopause”, contact your menopause specialist and have them develop an individual program to meet your bone health needs.
My motto: Suffering in Silence is OUT! Reaching out is IN!