Menopause: how to take care of bones in this phase – 07/10/2023 – Health

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It is natural that, as we age, our body has a loss of bone mass, with rates that reach up to 2% reduction per year after the age of 50.

Yes, but how normal is this and when does it become a problem? Is there a way to prevent or remedy this loss? I listened to two experts who help answer these questions.

First, it’s important to know what makes bones more fragile. There are two main reasons:

1. With aging, the cells responsible for strengthening the bones are having their production reduced;

2. At the same time, the rate of reabsorption of calcium present in the bone is increased, in what is called osteopenia.

It is common for this loss of bone mass to take many years to reach a point of concern, when there is an increased risk of fractures. There are cases, however, in which it is accelerated by different factors:

Hereditary predisposition: People who have a family history of fractures or osteoporosis are more likely to be at risk for bone thinning..

Environmental factors: smoking, overweight and a diet low in calcium and protein.

Post menopause: many women have an increased risk during this period.

• Why? Estrogen, the main female hormone whose production is reduced after menopause, regulates bone loss. At a low rate, it fails to replenish calcium and bone resorption is accelerated.

About one in three women over 50 will experience some bone weakness or fracture, and up to one in four of these (24%) may die from the most serious condition, which is a hip fracture, a year after the accident baseline, according to research from the Osteoporosis Foundation.

Researchers point to two ways to try to stop postmenopausal bone loss:

1. Hormone replacement. It is done through estrogen pills or injections. It helps to put a “brake” on the fall of free estrogen and thus prevent the absorption of calcium.

• “In the first ten years after menopause, if there are no contraindications, I do hormone replacement and drastically reduce the risk of osteoporosis”, says the physician from the Brazilian Orthopedic Association of Orthometabolism, Cecília Richard.

2. Calcium supplementation. A diet rich in milk derivatives and proteins provides the necessary amount of mineral – about a thousand milligrams per day. A restrictive diet, such as vegan or vegetarian, or with low consumption of meat and dairy products, cannot fully provide the necessary amount of calcium.

• Not every vegan or vegetarian, however, will necessarily get osteoporosis, but it is an additional risk factor. Rheumatologist Laura Mendonça recommends replacement with supplements.

Is there a way to prevent bone loss? Yes, but experts suggest that preventing osteoporosis is not just a concern for people over 60, when bone loss is already a reality.

Prevention should start early, with the practice of physical activity. It helps strengthen muscle, which protects bones. The Dr. Cecília Richard points out that, in this way, “elderly people, for example, may suffer a fall, but it will not have as strong an impact as on a person who is not in adequate physical shape”.

News: in March, the Ministry of Health incorporated two new treatments for osteoporosis.

• teriparatidea parathyroid hormone (PTH) analogue, which prevents calcium reabsorption;

• romosozumabanti-resorptive and osteo-forming, preventing reabsorption and helping to recompose the bone.

The new guideline, which should be published soon, will guarantee access for patients in the SUS.

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