Osteoporosis is a condition that makes the bones weak and fragile, increasing a person’s risk of fractures. Menstruating individuals have a higher risk of developing osteoporosis after menopause.

When a person reaches menopause — which causes menstruation to slow and eventually stop — their levels of the hormones estrogen and progesterone decrease. These hormones influence bone health, and lower quantities can lead to lower bone density.

Reduced bone density can cause osteoporosis, which is particularly common in postmenopausal individuals.

Keep reading to learn more about postmenopausal osteoporosis, including its symptoms, the treatment options, and more.

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Osteoporosis is a condition that causes bones to weaken as they become porous and lose density. Weakened bones are brittle and more likely to break.

This condition is more common in people who go through menopause.

Postmenopausal bone loss is linked to lower levels of the hormone estrogen. This hormone plays a major role in hormone metabolism, and it influences specialized bone cells called osteoclasts, osteoblasts, and osteocytes.

When estrogen levels drop, the bone cells do not reproduce at the same rate. As a result, a person’s bones lose cells faster than they can make new ones, causing low bone density.

As there are few noticeable symptoms of osteoporosis, the disease can progress without a person knowing. Often, a person with osteoporosis will not receive a diagnosis until they experience a broken bone.

Most commonly, fractures associated with osteoporosis affect the hip, vertebrae, or wrist. A person may also break other bones, such as those in the arm or pelvis. Something as minor as a cough or sneeze can sometimes cause a fracture.

In addition to broken bones, other symptoms can occur. These may include:

Menopause significantly accelerates bone loss, which increases a person’s risk of osteoporosis.

Bones comprise a network of proteins and minerals that provide them with the flexibility and strength that the body needs to support its movement. They also contain various specialized cells, such as osteocytes, that help maintain this network.

One factor that can affect the bone structure is the hormone estrogen.

Although experts do not know precisely how estrogen keeps bones strong, they believe that osteocytes create a protein called SEMA3A that maintains the bone matrix. They think that as people age and their estrogen and SEMA3A levels fall, osteocytes start to die, which leaves bone unable to maintain its structure.

If a doctor suspects osteoporosis, they may perform a bone density scan, called a DEXA scan.

This scan is relatively simple and painless, and it takes about 10–20 minutes. During the procedure, the person will lie on their back on an X-ray table.

A doctor will analyze the test results to determine the person’s bone density. They will usually then compare it with the bone density of a young adult, calculating the difference as a standard deviation (SD).

This calculation provides a T score. A T score of above -1 SD is normal, while a score between -1 and -2.5 shows some bone loss (called osteopenia), and a score of -2.5 or below shows bone loss that constitutes osteoporosis.

When treating osteoporosis, doctors aim to prevent bone fractures and breaks. They will also provide medication to help strengthen the bones.

A doctor’s treatment decisions depend on the results of their evaluation and the bone density scans.

Treatment options may include:

  • Selective estrogen receptor modulators (SERMS): These medications affect the bone in a similar way to estrogen, so they can help reduce the risk of fractures.
  • Bisphosphonates: These medications slow down bone loss. In this way, they maintain bone mass and density, reducing the risk of broken bones. Different types of bisphosphonates include risedronic acid, alendronic acid, zoledronic acid, and ibandronic acid.
  • Calcium and vitamin D supplements: Calcium is the main mineral in bone, and vitamin D helps the body absorb calcium. Experts recommend that adults consume at least 700 milligrams of calcium and 10 micrograms of vitamin D per day.
  • Hormone replacement therapy (HRT): Doctors sometimes recommend HRT for people who are going through menopause. Although HRT can help improve bone strength, experts do not recommend this treatment for addressing osteoporosis specifically because of its risks.
  • Parathyroid hormone: This hormone regulates calcium levels in bones. Parathyroid treatments, such as teriparatide, stimulate cells that create new bone.

Besides menopause, risk factors for osteoporosis include:

  • having a family history of the condition
  • having a low body mass index (BMI)
  • taking high-dose steroids for longer than 3 months
  • taking medications that can affect hormone levels, such as anti-estrogen tablets
  • having an eating disorder
  • drinking excess alcohol
  • smoking
  • having underlying medical conditions, such as hormonal conditions or inflammatory disorders

Postmenopausal osteoporosis is osteoporosis that results from decreased estrogen levels. There are usually no obvious symptoms, and people typically only realize that they have the condition once they have broken a bone.

A doctor may use a bone density scan to help diagnose a person with postmenopausal osteoporosis. They can treat the condition with medications, calcium and vitamin D supplements, and HRT.