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Bone Health

Understanding Bone Health During Menopause

It might be a surprising fact for you, but the strongest and apparently stable part of our body- our bones, are not so stable indeed! Our bones are very active “organs” in our body which keep remodeling themselves. Here’s how to take care of them during Menopause -
Dr. VP Raman
October 19, 2023

It might be surprising to learn that the apparently strongest and stable part of our body- our bones, are not so stable indeed! Our bones are very active “organs” which keep remodeling themselves. Let’s learn more about them.

Understanding the basics

You must have learnt that your skin sheds its cells and keeps making new cells. It’s the same with your bones! There is constant breakdown of bones and formation of new bones that take place. Bones have two types of cells- the osteoclasts that help in breaking down bone, and the osteoblasts which help in making new bone.

All through your life this tussle between the osteoclasts and osteoblasts goes on. The osteoblasts are way ahead of the osteoclasts when you are younger, with almost all bone formation being complete by the time you are 18 years of age. The osteoblasts thus have a very narrow window to act, with their action beginning by around 11-12 years when a girl attains menarche - the onset of her first period, to about 18 years of age.

The relationship between periods and bone health has to do with the hormone estrogen, which starts being produced by the ovaries with menarche. The age from 11 to 15 years is very important as the maximum growth of a girl’s bones takes place during this time.

What about men, you ask? 

Men also have a very small amount of estrogen in their bodies. Testosterone converting to estrogen, estrogen from fat tissue, as well as bone and skin are sources of estrogen in men. Apart from estrogen, testosterone also plays a role in bone mass in men.

The tide then turns for the osteoclasts (“bone breakers”) and they soon beat the osteoblasts (“bone makers”) as the onset of bone loss first begins in your spine while you are in your 20s.

Beyond the age of 30, the osteoclasts win further and bone breakdown in the axial skeleton- the spine and pelvis, starts to exceed new bone formation. Thus, bone loss starts in your 20s, accelerates after your 30s and keeps on increasing as you near menopause. This accelerated bone loss then continues for about five years after menopause, after which menopause-related bone loss is diminished but ageing-related loss continues.

Since this accelerated loss due to menopause doesn’t affect men, it is no surprise that men have stronger bones than women in this age group. 

Since bone loss begins in the 30s, it is recommended that you start taking care of your bones right from then. Unfortunately, this is also the time when we are busy with our families and careers and so we tend to ignore our health, including bone health, the knowledge of which, is generally limited. 

A healthy diet and regular exercise can help you keep your bones strong. That can happen only when you prioritize yourself. Sounds difficult? That is why at Elda Health, we are here to guide you through expert-led, holistic wellness. It’s our job to make bone health simpler for you!

If your bone loss begins in our 30s, it is obvious that you have to start taking care of your bones right from then. Unfortunately we all are so busy with our families and careers around this time that we tend to ignore our health and since we have limited knowledge about bone health our bones  are ignored too.

A healthy diet, good exercise can help you keep your bones strong. That can happen only when you prioritize yourself over all your other chores and duties. Sounds difficult? That is why we, at Elda Health are here to guide you through, expert led, holistic wellness. It’s our job to make bone health simpler for you!

Managing bone loss

There is a close association of bone health with menstruation - with bone formation after menarche, and bone loss towards menopause. This association is because of the hormone estrogen. Your body maintains a healthy level of estrogen and thus, good bone mass when your periods are regular.

Once you reach menopause, the estrogen level goes down and so does the bone mass.

Now since bone mass is predominantly formed between 11 to 14 years of age, it  goes without saying that the stronger the girl’s bones are built at this time, the denser her bone mass and hence, smaller the chance that the girl suffers from poor bone mass after menopause.

To understand what bone mass is, we should know how bones are built. Stronger bones are built in the presence of estrogen with a diet that has enough of calcium as well as Vitamin D. The routine bodily functions that are required to keep our body in equilibrium require a certain level of calcium in our blood. When the calcium level is low, the body tries to maintain the level by tsourcing calcium from the bone, thereby increasing bone breakdown and decreasing bone mass.

Know Your Bones

As bone breakdown begins after 30, bones start becoming porous. In case of a lower bone mass, this leads to “osteopenia”.  A further reduction in bone mass, or “bone mineral density,” leads to “osteoporosis," which literally means “porous bones”.  

This decreased bone mass is also a natural part of ageing. Apart from calcium, vitamin D and ageing, other factors like certain medications, body weight, excess caffeine, alcohol, smoking and a sedentary lifestyle play a role in determining bone breakdown, and hence our bone mass and bone strength.

Estrogen and menopause remain major contributors of bone loss in women.

The loss of bone in postmenopausal women is largely attributed to estrogen deficiency. 75% or more of the bone loss that occurs in the first 15 years of menopause is due to estrogen deficiency rather than ageing itself.

A diet rich in calcium and vitamin D, as well as regular exercise will help you have a higher bone mass and will reduce the chances of being affected by osteoporosis.

For more information on bone health, download the Elda Health app.