Bone Health

What is osteopenia?

Osteopenia is having a loss of bone mineral density (BMD), causing weakness to the bones. Osteopenia is not a disease, but it can mean that you're at higher risk for breaking a bone. Typically it is more prevalent in females with common risk factors for osteopenia being aging and menopause. After your bone mass peaks (around the age of 35), the body breaks down bone faster than it builds new bone. During menopause estrogen is reduced significantly, causing bone loss to speed up and increase the risk of low BMD.

What is osteoporosis?

Osteoporosis is a bone disease and condition that means the bone density and mass is so low that the bones are brittle, fragile, and can break or fracture easily. Osteoporosis develops slowly over several years and is often only diagnosed when a fall or sudden impact causes a bone to break or fracture. Fractures can occur in any bone but happen most often in bones of the hip, vertebrae in the spine, and wrist. A T score of -2.5 or lower indicates bone density low enough to be diagnosed as osteoporosis.

What happens to bones during the menopause transition?

The menopause transition holds significant physiological changes on bone health. It causes rapid losses in bone mass and strength, occurring after the final menstrual period. Osteoporosis and bone loss is common in menopause due to the estrogen deficiency and an increase in follicle stimulating hormone (FSH) during this period, causing a risk of bone fractures and bone weakening disorders. However, there are still important gaps in the knowledge around menopause transition and the effects on the skeletal system.

How to measure bone health?

Measuring bone health can be done in various ways, the most common and accurate test is the dual-energy x-ray absorptiometry (DEXA scan). This scan is a low dose x-ray that measures the bone strength, thickness and calcium of the bones, to determine the bone density and mass. Results from this scan are T-scores, these results compared bone density to the average bone density of healthy adults of the same age and gender. Allowing diagnosis of osteopenia, osteoporosis, predicting risk of future fractures or monitor treatment for osteoporosis. Normal bone density is a T score range of -1 to +1. A T score of -1 to -2.5 indicates osteopenia. A T-score of -2.5 or lower is bone density low enough to be diagnosed as osteoporosis.

How can you strengthen your bones?

With a compelling number of women being associated with the status of menopause and osteoporosis, it is essential to do exercise, especially strength training to ensure strong bones and reduce the risk of breaks or fractures. Middle-aged women tend to have smaller muscle mass than middle-aged males. Despite the few biological reasons for this, a lot of the decline in strength and muscle mass that occurs through perimenopause belongs to the lack of exercise stimulus along with biological reasoning. Women as a whole do not engage in enough exercise or strength training as men do.

Strength training should be a main priority of exercise for middle aged women and above, to help build bone around vulnerable areas such as the hips, spine, and arms to prevent osteoporosis. For both muscle and bone, it becomes much harder to increase once you are postmenopausal, compared to pre-menopause. Starting before the onset of menopause gives women the best chance at building the strength they will need for resilient aging. That being said, it’s never too late to start!