Post menopause, check your bone health with regular density and blood test, fracture risk assessment tool

Blood tests can measure levels of calcium, vitamin D, and other bone turnover markers like alkaline phosphatase and parathyroid hormone. (Image: Canva)

Post-menopause, women face an increased risk of bone health issues primarily due to hormonal changes. Estrogen, a hormone that protects bones, decreases significantly after menopause, leading to a reduction in bone density. This condition, known as osteoporosis, makes bones more fragile and susceptible to fractures. The decrease in bone density is most rapid in the first few years following menopause, highlighting the critical need for early intervention.

Lifestyle factors, such as inadequate calcium and vitamin D intake, physical inactivity, smoking, and excessive alcohol consumption, can further exacerbate the risk. Understanding the factors that contribute to bone health deterioration post-menopause is essential for implementing preventive measures. Regular check-ups, a balanced diet, and an active lifestyle are crucial for maintaining bone strength and reducing the likelihood of fractures during this stage of life.

Here are few ways to check your bone health after menopause as suggested by Manisha Sharma, gynaecologist and Mother and Child healthcare, Noida.

Bone density test (DXA scan)

What it is: A dual-energy X-ray absorptiometry (DXA) scan is a non-invasive test that measures bone mineral density (BMD). It typically targets the hip and spine, areas most prone to fracture.

Why it's important: DXA scans help diagnose osteoporosis and determine the risk of fractures. By comparing your bone density to a healthy young adult (T-score) and to people of your age (Z-score), doctors can gauge the severity of bone loss.

Frequency: Postmenopausal women, especially those with risk factors such as family history of osteoporosis, low body weight, or previous fractures, should have a DXA scan every 1-2 years to monitor bone health.

Blood tests

What they are: Blood tests can measure levels of calcium, vitamin D, and other bone turnover markers like alkaline phosphatase and parathyroid hormone.

Why they're important: These tests can identify deficiencies or abnormalities that affect bone health. For example, low vitamin D levels can impair calcium absorption, and high levels of bone turnover markers can indicate active bone loss.

FRAX tool

What it is: The fracture risk assessment tool (FRAX) is an online calculator developed by the World Health Organization. It estimates your 10-year probability of sustaining a hip fracture or other major osteoporotic fractures.

Why it's important: FRAX considers factors like age, sex, weight, height, previous fractures, family history of hip fractures, smoking, alcohol use, rheumatoid arthritis, and use of glucocorticoids. This comprehensive risk assessment helps healthcare providers make informed decisions about interventions to reduce fracture risk.

Physical exam and medical history

What it is: A thorough physical examination by a healthcare provider involves assessing your height, weight, posture, and overall health. A detailed medical history reviews lifestyle factors, medication use, and any previous fractures.

Why it's important: Detecting changes in height or posture can indicate vertebral fractures. Understanding risk factors like smoking, alcohol use, physical inactivity, and family history helps in assessing overall bone health and fracture risk.

Calcium and vitamin D intake assessment

What it is: Evaluating your diet to ensure you're consuming sufficient amounts of calcium and vitamin D, and possibly recommending supplements if dietary intake is inadequate.

Why it's important: Calcium is crucial for maintaining bone strength, and vitamin D enhances calcium absorption and bone growth. Deficiencies in either can lead to weakened bones and an increased risk of fractures. Adults over 50 should aim for 1,200 mg of calcium and 600-800 IU of vitamin D daily.

Exercise and physical activity evaluation

What it is: Assessing your level of physical activity, with an emphasis on weight-bearing and muscle-strengthening exercises. Activities such as walking, jogging, dancing, and strength training are beneficial.

Why it's important: Regular physical activity helps maintain bone density and strength. Weight-bearing exercises stimulate bone formation, and muscle-strengthening exercises enhance balance and coordination, reducing the risk of falls and fractures.

Tips for maintaining bone health post-menopause

Adequate calcium intake: Ensure you're getting about 1,200 mg of calcium per day through a combination of dietary sources (such as dairy products, leafy greens, and fortified foods) and supplements if necessary. Calcium is essential for maintaining bone strength.

Vitamin D: Obtain sufficient vitamin D through sunlight exposure, diet (such as fatty fish and fortified foods), or supplements (600-800 IU/day recommended). Vitamin D is crucial for calcium absorption and bone health.

Regular exercise: Engage in weight-bearing and muscle-strengthening exercises regularly. Activities like walking, jogging, dancing, and resistance training are particularly effective at maintaining bone density and overall health.

Avoid smoking and limit alcohol: Smoking and excessive alcohol consumption can weaken bones. Smoking reduces blood flow to the bones, slows the production of bone-forming cells, and impairs calcium absorption. Alcohol interferes with the balance of calcium and the production of bone-forming cells.

Medications: Consult your Dr about medications that can help prevent bone loss if you are at high risk. Bisphosphonates, selective estrogen receptor modulators (SERMs), and hormone replacement therapy (HRT) are some options that may be considered.