At some point, all women go through menopause. At first, monthly periods become less regular and can be heavy or light, or both at different times. Hot flashes and night sweats can occur at this time. This is called perimenopause. A woman reaches menopause when her periods stop completely. This transition happens naturally over time. In some women it takes less than a year. In others it can take two or more years.
At some point, all women go through menopause. At first, monthly periods become less regular and can be heavy or light, or both at different times. Hot flashes and night sweats can occur at this time. This is called perimenopause. A woman reaches menopause when her periods stop completely. This transition happens naturally over time. In some women it takes less than a year. In others it can take two or more years. During this time, you may feel physical and emotional changes. Or, you may feel no symptoms at all.
Menopause happens when the ovaries stop producing estrogen. If you have your ovaries removed by surgery, menopause happens instantly. Either way it happens, menopause results in low estrogen levels, which can lead to bone loss. For some women, this bone loss is rapid and severe.
Two major factors that affect your chance of getting osteoporosis are:
- The amount of bone you have when you reach menopause. The greater your bone density is to begin with, the lower your chance of developing osteoporosis. If you had low peak bone mass or other risk factors that caused you to lose bone, your chance of getting osteoporosis is greater.
- How fast you lose bone after you reach menopause. For some women, bone loss happens faster than for others. In fact, a woman can lose up to 20% of her bone density during the five - seven years following menopause. If you lose bone quickly, you have a greater chance of developing osteoporosis.
Finding out if you have osteoporosis
If you’ve reached menopause, ask your healthcare provider when you should have a bone density test. Your other risk factors for osteoporosis and broken bones can help you and your healthcare provider to decide when you should have a bone density test. This test can help you learn if you are at risk for osteoporosis or if you already have it. Knowing this information can help you make decisions about treatment before you lose too much bone and are at risk for broken bones.
What about taking estrogen?
If you have menopausal symptoms, such as hot flashes, your healthcare provider may prescribe estrogen therapy (ET) or estrogen with progesterone hormone therapy (HT). Some women are advised not to take ET or HT because of the possible risks. Risks may include breast cancer, strokes, heart attacks, blood clots and cognitive (mental) decline. It’s important to discuss the risks and benefits of your treatment options with your healthcare provider.
If you decide to take ET or HT to control your menopausal symptoms, you can also help to prevent bone loss. Because of the possible risks associated with ET and HT, you should take the lowest possible dose for the shortest possible time to control your symptoms. The risks and benefits of the many different forms of ET and HT may vary. For example, you may be able to take a pill, patch, injection or other form. Women who have early menopause or their ovaries removed in their 20s, 30s or early 40s may be able to take a low dose of ET or HT. Women who have had breast cancer or have a high risk for breast cancer should not consider ET or HT.
For more comprehensive information, download NOF’s resource Hormones and Healthy Bones [1]
Additional Related Topics
Having a BMD Test [2] - Information about bone density testing, and understanding what your results mean.
