Osteoporosis & Menopause
The average woman loses up to 10 per cent of her bone mass in the first five years after menopause. Research suggests that about half of all women over the age of 60 years will have at least one fracture due to osteoporosis.
Peak bone mass is usually reached during a woman’s 20s to 30s when the skeleton has stopped growing and bones are at their strongest. As women go through menopause there is a significant fall in the hormone, oestrogen. Oestrogen is important to new bone production because it supports osteoblasts, which are bone-producing cells. Without oestrogen, osteoblasts can't produce enough new bone, and eventually, osteoclasts (bone-absorbing cells) overpower them. That's why post-menopausal women are at a higher risk of osteoporosis.
Osteoporosis is a normal part of ageing for everyone. It occurs when bones lose minerals, such as calcium, at a faster rate than the body can replace them. Bone density becomes thinner and in severe cases a minor bump can cause a fracture. Some women develop osteoporosis early because of illness. Women with breast cancer are at increased risk of developing osteoporosis because of the treatments used in breast cancer. Treatments can impact directly on oestrogen levels (vital for bone strength), resulting in a reduction in oestrogen and a premature/early menopause.
Osteopenia is essentially lower bone density, where bones have lost some mass and strength. In osteopenia the bone density is between normal bone density and osteoporosis. A woman with osteopenia has a risk of broken bones that is higher than normal, but not as high as with the more severe effects of osteoporosis.
Often the first sign of osteoporosis is a fracture, as osteoporosis causes no symptoms. Some early signs and symptoms that can point toward bone loss are;
Receding gums Your gums can recede if your jaw is losing bone.
Weaker grip strength Researchers have found that low handgrip strength was linked to low bone mineral density. In addition, lower grip strength can increase your risk for falls.
Nail strength can signal bone health. But you should also take into consideration outside factors such as swimming, gardening, and other exercises that may affect your nails.
The roles of Vitamin D and Calcium.
Calcium and Vitamin D go hand in hand. Vitamin D is needed for uptake of calcium to the skeleton. Calcium an essential nutrient in healthy bone development. Calcium is also critical for cell function. Our bodies can’t make calcium, if calcium levels decrease, the body will make up for this by taking calcium out of bones and putting it into the blood.
The role of exercise to maintain bone health. Exercise builds and maintains strong bone density. Weight bearing exercise, where you bear your own weight and support your skeleton. This includes fast paced walking (to have an effect on your bones), running, tennis or dancing. High intensity refers to weight bearing exercises that also involves load placed through the skeleton which stimulates bone cell formation. Movements such as during landing or after lifting your own body weight off the ground. Examples include running, skipping, jumping.
“Pilate’s is an ideal form of exercise for osteoporotic clients and for osteoporosis prevention. The exercises are controlled and balanced. Weight bearing can be achieved on the equipment with spring resistance. Working in closed or pseudo closed chain allows for controlled concentric and eccentric loading of the bones.” (J Guest, 2022, BSc Physiotherapy).
Recent studies have also shown that swimming is helpful, since it requires your body to move against the resistance of the water. Physical activity improves muscle strength density to support bones as well as balance and overall fitness, which may assist in reducing the risk of falls and fractures.
In closing
Please consult with your GP before beginning any form of exercise. Please use your own judgment with regards to your body's needs as to the suitability of any movement.
References
Jean Hailes for Women’s Health. Bone health. https://www.jeanhailes.org.au/
Australian Menopause Society. Osteoporosis.
Pilates Alliance of Australasia. Pilates for osteoporosis. 2022.