Welcome to our Doctor’s Q&A corner!

It’s our third edition and we’re excited to launch this brand-new section, featuring insights from Dr. Virdi.

Remember, if you’ve got general questions about perimenopause or menopause symptoms, management tips, or lifestyle advice, send them our way! Submit yours for the next edition!

Question: "With the hormonal changes of perimenopause/menopause, how can I best protect my bone health and reduce my risk of developing osteoporosis? Should I have a bone density test at this stage?"

Answer:

Bone health, particularly in women, is very important as we age. Naturally, the bones become more fragile with age, decreasing density and structural deterioration and can develop into conditions known as Osteopenia in the early stages, and Osteoporosis in the later stages. Therefore in older age one is more prone to fragility fractures, particularly the hip, spine and wrists. A hip fracture in old age is serious, it significantly affects independence and increases mortality in women to 70% within a year if the fracture is not operable! Hence the importance to look after bone health throughout adulthood.

The added factor with peri/menopause is that the decline and eventually lack of female hormones (oestrogen and progesterone) also increases the risk of osteoporosis. This can be an issue particularly if women have early menopause (generally under the age 45) as there is then a need to take extra medication to prevent osteoporosis, usually in the form of HRT (hormone replacement therapy) if suitable for the individual female, or other bone protection medication called Bisohosphonates. This can be discussed with a GP.

There are several ways every female can help prevent osteoporosis with lifestyle factors alone.

Firstly the diet; having adequate Calcium which is usually in the form of dairy products, greens or supplements at 1000-1200mg/day. Vitamin D which is received by the sun through the skin, but during winter periods should be taken as a supplement at 1,000unit tablets daily. Adequate Vitamin D levels are also necessary for calcium absorption. And plenty of protein to improve muscle strength which in effect helps bone mineral density.

Secondly the exercises; Weight-bearing exercises such as walking, hiking, dancing, jogging are all good for strengthening bones. Strength-training exercises with weights and resistance bands help bone density. Balance exercises such as yoga and pilates help improve stability and prevent falls and fractures. It's never too late to join a gym!

Thirdly the lifestyle habits such as smoking and drinking alcohol in excess affect bone density. So stopping smoking and limiting alcohol to 14 units per week.

Bone density scans are not usually arranged on request, but may be required in certain circumstances. Risk factors to indicate a bone density scan include: previous fragility fractures, smoking or drinking alcohol in excess, a low body mass index (BMI), early menopause under 45 years of age, taking oral steroid medication for a long period, existing medical conditions such as rheumatoid arthritis, or a family history of bone fractures. Depending on the result and level of bone density, bone protection medication may be required in the form of Bisohosphonates tablets taken once weekly, or HRT if started under the age of 60. Then the bone density scan is usually repeated after 3 years to look for an improvement in the bone density. This again can be discussed with a GP first if appropriate.