Osteoporosis in Women
The Effects of Menopause on Bone Strength, Calcium & Osteoporosis and the Influence of Estrogen on Osteoporosis.
Menopause is characterized by the loss of estrogen production by the ovaries. This may occur by natural means or by the surgical removal of both ovaries. This loss of estrogens accelerates bone loss for a period ranging from 5 to 8 years. In terms of bone remodeling (explained in detail on a previous page) the lack of estrogen enhances the ability of osteoclasts to absorb bone. Since the osteoblasts (the cells which produce bone) are not encouraged to lay down more bone, the osteoclasts win and more bone is lost than is produced.
It is well established that estrogen replacement during menopause protects bone mass and helps protect against the risk of osteoporotic fractures. The accelerated bone loss during menopause has little relationship to the amount of calcium intake. After age 60, however, the proper attention to calcium intake is very important and has been shown to increase bone density. An important study published in 1992 showed that elderly women who took supplemental dietary calcium (with vitamin D) had a 30% less fractures (including hip fractures) than similar women who did not take supplemental calcium. When these investigators looked at these women again 3 years later, they still had a significantly less rate of fractures, and, they had a 15 % decreased chance of death. Most endocrinologists feel that the use of calcium supplements are safe (and inexpensive) and recommend it to most (all?) elderly men and women unless specific contraindications exist.
The role of androgens (testosterone) in males is less well understood, but the loss of testosterone will increase the rate of osteoporosis in men.