Stuff about bone and osteoporosis during and after the menopause transition
“The Menopause Transition: Signs, Symptoms, and Management Options”
Menopause and perimenopause have been picked up by mainstream news recently. For the next two weeks the daily doctor will breakdown the Endocrine Society’s 2021 article on this topic:1
“The Menopause Transition: Signs, Symptoms, and Management Options”
The article presents a “mini-review” of “758 published epidemiologic, population-based studies, and studies of reproductive physiology […]”
“[…] to discuss the basic pathophysiology of the menopausal transition and the hormonal and nonhormonal management of clinicopathology attributed to it”
So what does the Endocrine Society say about Menopause Transition?
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Select quotes from the endocrinologists:
“Estrogen is a potent antiresorptive agent at the bone level, and thus hypoestrogenism of menopause marks a period of increased rate of bone resorption.”
“Osteoporotic fractures affect half of women after age 50”.
“Rates of bone loss increase dramatically starting a year before the [final menstrual period] and persist up to 3 years with rates of bone loss as high as 5% per year, then slows again to approach the rate of loss prior to menopause”.
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Select quotes from the Australasian Menopause Society
The Australasian Menopause Society provides more information with their factsheets for health professionals:-
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Osteoporosis:2
The menopausal transition is associated with significant bone loss due to the decline in oestrogen.
Worldwide, osteoporosis causes more than 8.9 million fractures annually and one in three women over the age of 50 will experience a fracture.
After menopause, oestrogen levels drop and this results in accelerated bone loss. The average woman loses up to 10 per cent of her bone mass in the first five years after menopause.
Data from Healthy Bones Australia suggest that 27% of women age ≥60 are osteoporotic and 51% of women ≥60 are osteopaenic.
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Falls and fractures:3
Falls are the main cause of fractures or broken bones at any age.
1 in 5 women will fall each year before they reach 60.
After 65 years 1 in 3 will fall each year.
Women over 80, 1 in 2 will fall each year.
After the age of 50, 1 in 2 women will suffer a broken bone (fracture) due to a fall in their remaining life-time.
Risk of falling is increased with 3 or more medical conditions, 4 or more medications,
age, vision or hearing decline, sarcopenia [ed: loss of muscle mass (and therefore strength and function)]
syncope [ed: blacking out, loss of consciousness],
poor balance, slower gait,
vascular diseases, Diabetes, Parkinson’s disease, dementia
urinary incontinence.
The rate of falls-related fractures is inversely related to bone density.
Women over 60 with osteoporosis (T score <-2.5) have double the risk of falls of those with normal bone density (BMD).
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Santoro N, Roeca C, Peters BA et al. The Menopause Transition: Signs, Symptoms, and Management Options. J Clin Endocrinol Metab, 2021; 106(1): 1-15.
Australasian Menopause Society: Health Professionals: Information Sheets: Osteoporosis. <https://www.menopause.org.au/hp/information-sheets/osteoporosis> Updated Jul, 2023. Accessed Jul 04, 2025.
Australasian Menopause Society: Health Professionals: Information Sheets: Prevention of falls and fractures. <https://www.menopause.org.au/hp/information-sheets/prevention-of-falls-and-fractures> Updated Apr, 2019. Accessed Jul 04, 2025.