By Dr. Njalalle Baraza
JUNE 16 -Menopause is often discussed in terms of hot flushes, mood changes, and the end of fertility. Yet one of its most serious consequences receives far less attention: bone loss. As women transition through menopause, declining estrogen levels silently weaken the skeleton, increasing the risk of fractures, disability, and loss of independence. It is a public health issue that deserves greater awareness and action.
According to the World Health Organization (WHO), most women experience menopause between the ages of 45 and 55, accompanied by a significant decline in circulating estrogen. This hormone plays a critical role in maintaining bone density. As estrogen levels fall, bone breakdown begins to outpace bone formation, accelerating bone loss and increasing the risk of osteoporosis.
The scale of the problem is staggering. The International Osteoporosis Foundation estimates that one in three women over the age of 50 will suffer an osteoporosis-related fracture during their lifetime. Worldwide, an estimated 37 million fragility fractures occur every year among adults aged over 55, equivalent to nearly 70 fractures every minute. These are not merely statistics. They represent mothers, grandmothers, sisters, and professionals whose quality of life can change dramatically after a seemingly minor fall.
The danger is that osteoporosis is often silent until a fracture occurs. A woman may feel healthy and active, yet her bones could be gradually weakening. Recent evidence shows that women can lose up to 20% of their bone density within the first five years after the onset of menopause. Fractures of the spine, wrist, ankle and hip are among the most commonly encountered by orthopaedic surgeons. Hip fractures are particularly devastating, often leading to prolonged hospitalization, reduced mobility, and increased dependence on caregivers.
The good news is that bone loss is not inevitable. Prevention starts long before menopause. Regular weight-bearing and resistance exercises, such as walking, hiking, squats, and strength training, help build and maintain bone mass. A diet rich in calcium and vitamin D, combined with adequate exposure to sunlight, provides the nutrients required for healthy bones. These lifestyle choices create a stronger foundation that can better withstand the hormonal changes of later life.
Women should also be encouraged to discuss bone health with their healthcare providers. Bone density screening through Dual-Energy X-ray Absorptiometry (DEXA) scans can identify early bone loss before fractures occur. For women at higher risk, treatment options including vitamin D supplementation, bisphosphonates, and hormone therapy may help preserve bone strength and reduce fracture risk. Medical advances have made hormone therapy safer and more targeted than in previous decades, making informed discussions with healthcare professionals more important than ever.
As life expectancy continues to rise, healthy ageing must become a priority. Menopause should not be viewed as the beginning of decline but as a stage of life that requires proactive health management. Strong bones mean mobility, confidence, independence, and dignity. By investing in prevention, screening, and awareness today, women can continue to lead active and fulfilling lives for decades after menopause.
The Writer is a consultant orthopedic surgeon
