Menopause: Bone Loss and HRT

Menopause affects more than 40 million women between the ages of 45 and 55. Because American women have a life expectancy of 82 years, most women will spend about one-third of their lives in postmenopause.

Many women consider menopause a time to re-evaluate their lifestyles and do what they can to have a productive future. Your physician can help.

What Causes Menopause?

Menopause occurs as your body -- naturally or because you have had surgery to remove your ovaries -- shows its production of estrogen and progesterone. Menstruation ends, and you can no longer bear children.

What Are the First Signs?

Between 45 and 50, you'll probably see a change in your menstrual patterns. Your periods may be heavier, lighter, closer together or further apart.

A year or two before menopause, your periods probably will become further apart and then stop. Some women, however, menstruate regularly until their final period.

Most women notice two symptoms from the decrease in estrogen and progesterone:

  • 50 to 85 percent of women will have hot flashes
  • a loss of moisture and elasticity in the vagina can cause irritation and painful intercourse

Other discomforts may include headaches, fatigue, mood swings, weight gain, decreased sexual desire and forgetfulness.

The Role of Calcium

Calcium is important during this time, as well as throughout your life. But especially now, because your ovaries produce less estrogen and progesterone during menopause, so you can expect to lose bone mass. The most severe bone loss occurs during the first five years of menopause. The rate of loss slows after you reach 65-70.

Most women don't realize their bones are becoming weaker, because the symptoms of bone loss are silent.

The loss of estrogen also lowers your body's efficiency to absorb calcium, and more calcium is excreted when you urinate. National nutrition surveys show that women lose more bone mass than men, because women can't retain as much calcium.

Unfortunately, most menopausal women have a low calcium intake. Often this happens when women remove dairy products from their diet to lower their fat intake and prevent weight gain. The average American woman gets between 400 and 500 milligrams of calcium daily, when the recommendation for menopausal women is 800 milligrams daily.

This poor nutrition occurs when you are losing about 1.5 percent of your bone mass each year. At this rate, if you reach menopause at 50, you will have lost 15 percent of your skeleton by 60.

If you don't routinely eat cheese or drink milk -- low-fat and no-fat products are excellent source of calcium -- you should take daily calcium supplements of between 1,200 and 1,500 milligrams daily, according to the National Osteoporosis Foundation.

What About Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is optional. About 10 percent of American menopausal women take HRT, and about half of them stop taking the hormone after six to eight months. Although HRT helps prevent osteoporosis and heart disease, long-term HRT can increase your risk for some forms of cancer.

Discuss HRT with your physician. He or she will discuss the therapy's pros and cons with you and help you determine what's best for your needs.

Also talk with your physician about exercise, nutrition and what lifestyle changes you may need to make to ensure your continued good health.