Postmenopausal Osteoporosis, which can affect the quality of life, is considered the most common disease in women after menopause.¹ The World Health Organization defines “menopause” as the ceasing of menstruation for 12 consecutive months with the absence of etiological reasons. During the transitional period of menopause, women can experience many unpleasant symptoms, such as hot flashes, night sweats, and mood swings.

What is postmenopausal osteoporosis? 

Bone fragility or osteoporosis is a multifactor metabolic disorder that affects the bones. A decrease in the mineral density of the bones and a subtle deterioration of the bone’s tissue structure are observed in osteoporosis, which leads to weakening in the bone’s structure and therefore bone fragility.¹ In this case, the bones are more prone to fractures. 

Osteoporosis is called a “silent disease” because the weakening and loss of bone structure occur initially without any symptoms. Usually, people with osteoporosis don’t realize they have it until their bones are so weak that a sudden strain, bump, or fall leads to a fracture or collapse of one of the vertebrae. Collapsed vertebrae can be felt or noticed in the beginning by severe back pain, loss of height, or spinal deformities such as stooped posture.²

Menopause is the most common cause of osteoporosis. Therefore, osteoporosis is more dangerous and more common in females. Women are more likely to develop osteoporosis after menopause due to the hormonal changes they go through to accommodate the natural changes that occur in the body. The fluctuation of hormones is accompanied by fluctuating estrogen levels, which decrease. Estrogen is a hormone that helps maintain bone health by slowing natural bone deterioration. So when estrogen decreases after menopause, that greatly accelerates bone loss.³

What are the causes of osteoporosis in postmenopausal women? 

after menopause, and over time,  a decrease in the level of certain hormones in the body (such as estradiol) can lead to osteoporosis. This occurs in two phases: 

• The first phase: Begins at the age of menopause, and it occurs due to a lack of estrogen, as we mentioned earlier. Which leads to a disproportionate increase in bone resorption compared to its formation. This stage can be defined as the bone loss associated with menopause. 
• The second phase: It appears after 4-8 years, in which there is a slower continuous loss of many bones in the body. It is mainly due to the decline in bone formation, caused by aging. This phase can be seen in men as well.¹

What are the methods of prevention and treatment of PO? 

It is possible to start taking preventive measures against osteoporosis which affects postmenopausal women, starting from childhood or adolescence. Preventive measures include:

• It is recommended to reduce coffee and soft drinks as they interfere with calcium absorption.
• It is also recommended to reduce alcohol intake because it increases the loss of bone mass.⁴ 
• A balanced diet rich in vitamin D and calcium must also be maintained. 

Certain lifestyle changes may help prevent osteoporosis. Including:

• Sports exercises: Some types of exercise (such as resistance training, balance exercises, and weightlifting) help maintain bone health.
• Exposure to sunlight regularly, as the sunlight helps produce vitamin D, which is important for maintaining bone health.
• Weight management: Preventing obesity helps maintain bone strength. 
• Avoid smoking, as this can help reduce the risk of osteoporosis.³

As for treatment, there are many medications and hormonal treatments to reduce bone loss and stimulate the formation of new bone, including the following: 

• Bisphosphonate: It is used orally and helps reduce osteoporosis. 
• Denosumab: an intravenous drug that reduces the risk of bone fractures. 
• Abaloparatide: A bone-building medicine that is given as an injection. 
• Estrogen therapy: Prevents osteoporosis by reducing bone deterioration.³ 

And many other therapeutic medicines have proven effective in reducing the effects of osteoporosis in women and reducing the risk of fractures resulting from it.

The appropriate medication and dosage are determined by the doctor, so we do not recommend taking any medications without consulting your orthopedist. 

How can someone overcome and deal with osteoporosis? 

If you suffer from osteoporosis, it is very important to avoid any falls that could lead to a fracture. Falls can be avoided indoors by: 

1. Keeping the home floor clean and free of clutter. 
2. Ensure that the lighting is bright enough to enable you to see your surroundings. . 
3. Some walking aids, such as crutches, can also be used. 

Also, to avoid deterioration of the condition, it is important to follow up with the doctor to take the necessary medications, follow the appropriate diet, and practice some sports activities that the doctor may recommend. 

If you live with or know someone who suffers from osteoporosis:

• Ensure that they take the medications prescribed by the doctor.
• Help them do some exercise. 
• Help them keep their house floor clean. Ensure that it is free of any slippery materials or scattered items such as electrical wires and others. 
• Help them with any physical activity that may be difficult for them, such as walking. 
• Finally, and most importantly, provide them psychological assistance and be there for them. 

We, as the Uplifting Syrian Women initiative, encourage everyone, especially women, to take preventive measures to avoid osteoporosis after menopause, as it is a very common disease. We also advise women who are going through menopause to conduct the necessary examinations, such as checking bone density regularly.

Finally, we advise people with osteoporosis to keep in touch with their supervising doctor and to commit to all their instructions and recommendations. We wish everyone well recovery.

Also read:

• Premenstrual Dysphoric Disorder (PMDD)
• Polycystic Ovary Syndrome (PCOS)
• Interstitial Cystitis (IC)

References:

[1] NIH

[2] Web MD

[3] Endocrine

[4] Women’s