One of the most clinically significant effects of menopausal estrogen decline is bone loss. During menopause, women experience hormonal changes that affect many parts of their body. After a steady supply of estrogen and progesterone during their adult life, women start to lose these hormones in their perimenopausal stage.
Menopause begins after one year passes from the last menstrual period. Menopause is characterized by low levels of reproductive hormones including estrogen and progesterone. These hormones contribute to every woman’s health. In addition to their role in regulating reproductive function, they also play a role in bone health.
Estrogen is a key regulator of bone breakdown and remodeling. Normally, estrogen stimulates bone-producing cells called osteoblasts while inhibiting others that break down bones. When estrogen levels start falling during menopause, bone mineral density (BMD) deteriorates quickly. A decrease in bone density results in osteoporosis – a musculoskeletal disease characterized by weak, fragile bones and a higher risk of bone fractures.
In osteoporosis, as bone density decreases, some bones can collapse or break more easily. Women with osteoporosis most commonly experience symptoms in their hips, wrists, ribs, and spine. For example, vertebra can collapse resulting in back pain, loss of height, and a stooped posture. Pain occurs during physical activities such as walking, standing, or bending movements.
Due to their diminished estrogen levels, menopausal women are more susceptible to develop osteoporosis. They typically lose around 20 percent of their bone density during the first five to seven years after menopause. However, other can experience a slower or faster decline rate.
To accurately evaluate bone density, menopausal women can do several tests to check their bone health. The most common BMD diagnostic test is the DEXA x-ray scan. The DEXA scan measures bone density in the form of a T score. T scores of -1.0 and higher are normal whereas scores ranging from -1.0 and -2.5 indicate weak bone health, or osteopenia. Women with T scores lower than -2.5 means they have osteoporosis and require treatment.
Hormone replacement therapy (HRT) can help alleviate the majority of menopausal symptoms. HRT protocols replace the lost estrogen and progesterone with external bioidentical hormones. After administering HRT, estrogen levels begin to rise again, leading to a decrease in menopausal symptoms.
HRT preserves bone during menopause. Study findings show that women who start HRT in their late 40s can prevent the drastic drop in bone density, thus lowering bone loss and fracture risk.
At Hormone Replacement Therapy, Dr. David Nazarian and his qualified medical staff provide HRT treatments for perimenopausal and menopausal women. Prior to starting HRT, women discuss their menopausal symptoms with a specialist first. A detailed medical history is required to assess duration and severity of symptoms as well as preexisting conditions.
HRT is not suitable for all women. For example, women with a history of heart disease or breast cancer may not be eligible for HRT due to its side effects. It is important to disclose all medically relevant information with your doctor.
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