Risks Of Osteoporosis

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By Dr Mark Chong

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Menopause is the natural biological process women go through that marks the end of their reproductive years in the 40s and 50s.
The process is gradual and causes significant hormonal changes, resulting in many unique symptoms such as hot flashes, mood swings, sleep deprivation, moodiness and irritability. 
Menopause has three stages signalling the permanent end of menstruation. At the last stage, postmenopausal, estrogen and progesterone levels start to decrease. The lack of estrogen is directly shown to have an impact on bone density, leading to osteoporosis, a condition where bones become weak and brittle over time, making them more prone to breaks or fractures. 
It is important to note that in the first five to seven years of menopause, women are at greater risk of losing 20 per cent of bone density, making them susceptible to osteoporosis. It is also important to note that decreased estrogen levels are not the main cause for osteoporosis, if combined with other factors, osteoporosis can progress faster. 
Unfortunately, the disease continues to remain underdiagnosed and undertreated in Malaysia, making it harder to document its prevalence in our society.
According to Bone Health Alliance Malaysia (BHAM), 77 per cent of Malaysian women are living with undiagnosed postmenopausal osteoporosis (PMO).
While the cause may not always clear, researchers have found a specific connection between menopause and osteoporosis. 
Estrogen plays a critical role in maintaining bone strength, hence it is unsurprising that women reach peak bone mass at around 25-30 years, when the skeleton stops growing and bones are at their strongest and thickest. Therefore, when menopause occurs on average at the age of 50, estrogen levels drop, resulting in increased bone loss. 
If the peak bone mass before menopause is less than ideal, any bone loss that occurs around menopause may result in osteoporosis.
Since there are no obvious symptoms, many people do not realise they have the disease until a fracture happens. However, there are things that women can look out for:

Fragility related fractures

Even when milk impact results in a fracture of the wrist, back, hip or other bones.

Loss of height

Over time, more than two inches of height is lost.

Receding gums

As the jaw is losing bone density, and teeth are connected to the jawbone, receding gums become obvious.

Stooped or curved spine 

Because this disease also affects the vertebrae, the spine can eventually become more curved.

Lower back pain

Due to a weakened spine, the back is affected as it cannot handle normal stress the way it could prior to the disease
Treating osteoporosis with continuous bone care and regular treatments are important to prevent serious, damaging consequences later on.
Fortunately, there are some at home practices we can incorporate in our daily lives to help prevent osteoporosis after menopause.
Early introduction of these practices does help reduce the effects of osteoporosis later on. 

Here are a few tips to reduce the risk of osteoporosis

Consume proper supplements to boost bone health

Supplements such as Vitamin D helps the body absorb calcium as we should have an intake of at least 1,000 mg per day, with a recommendation of 1,200 mg per day for postmenopausal women. Similar to calcium, proper intake of vitamin D can reduce the risk of osteoporosis. Milk, salmon, orange juice, yogurt, and cereal are dietary sources of vitamin D. There is also a discussion of going on hormone therapy which essentially pumps the body full of estrogen to halt further increase of bone loss.

Consuming a healthy diet

The optimal diet for bone health involves getting plenty of protein and vitamin K. Vitamin K which is present in leafy greens helps increase bone density and reduce hip fractures. 

Exercise

Exercise involving high impact and muscle strengthening should be incorporated to help maintain bone density. Recommended exercises include strength training, walking or jogging, and jumping rope. By doing this, bones will respond by creating stronger, denser cells.

Avoid unhealthy habits

Chronic, heavy alcohol use is associated with an increased risk of osteoporosis, so keep consumption moderate. Additionally, smoking can be detrimental to our health and slows the production of bone-producing cells. 
Termed as the ‘silent disease’, osteoporosis often goes unreported, underestimated and therefore, remain undertreated. Timely screening and early detection of osteoporosis can play a significant role in reducing the risk of the orthopaedic condition, and facilitate treatment before it becomes severe.

About the author: Dr Mark Chong pictured above is the Consultant Trauma and Orthopaedic Surgeon at ALTY Orthopaedic Hospital. This is an opinion column. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of this publication.

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