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Managing Osteoporosis Risk During Menopause: A Naturopathic Perspective

Did you know that estrogen inhibits bone break down? Did you know progesterone increases bone building?

The reduction of estrogen and progesterone has a big impact on postmenopausal bone health which is why I talk about osteoporosis with all my patients.

Osteoporosis and bone health after menopause - risk factors and tips to protect your bones



How can we assess Osteoporosis Risk?

Although estrogen and progesterone will impact osteoporotic risk there are other factors to take into account as well. A really handy calculator can be found here, (below is a screenshot of what the calculator looks like). You can see that it'll take into account in addition to your age and sex, variables such as fracture history, smoking, medications, certain diseases, alcohol consumption, and values from previous bone scans if you have had them.



What can I do to keep my bones as healthy as possible?

This should be great to hear because there are lots of things you can do! I could honestly write a whole blog post about each one ( and I just might in the future), but a quick list includes:

  • Weight-bearing exercise - I love ones that include working on balance as this is also going to reduce how likely you are to fall and then break your hip etc.

    • Resistance exercise improves bone mineral density. 

    • Walking briskly 4-5 times per week improves bone density. However, walking on its own DOES NOT improve osteoporosis fractures

    • Aquatic exercise helps prevent the loss of bone density. 

  • Sleep well - melatonin increases bone mass via supporting bone-building osteoblasts and reduction of bone resortpion. You may benefit from melatonin supplementation as our natural production of this hormone decreases with age.

  • Nutrition - ensure you don't have any nutritional deficiencies. Deficiencies in protein, calcium and vitamin D have a significant impact on bone health. If your diet is low in protein (such as a vegan diet or dairy free diet) you may benefit from a protein replacement or changes to your diet that focus on these nutrients. 

    • Include 5 prunes per day in your diet. Prunes have special properties that impact bone health over the course of 6 months. Include 5 prunes daily. 

    • Increase the anti-inflammatory properties of your diet. Saturated fat, processed foods and trans fats all increase inflammation in the diet and have a negative impact on bone. Focus on a Mediterranean style diet with abundant olive oil, fruits and vegetables and lean protein sources. 

  • Reduce alcohol and smoking


What about Medications?

Your GP may recommend a drug from the medication class of 'bisphosphonates', such as zoledronic acid or risedronate. The medical concensus is that they can effectively reduce the risk of osteoporotic fracture. That being said, there's the most evidence for their use in preventing secondary fractures and not for primary. The adverse effects for them include low incidence of atrial fibrillation, esophageal cancer, and osteonecrosis of the jaw. Treatment protocol may include a 3-5 year 'drug holiday' to reduce the chance of those side effects happening.



Have you thought about your risk of osteoporosis before?

  • No I hadn't

  • Yes


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