The most important long-term effect of reduced oestrogen involves the effects on the skeleton. With age and reduced oestrogen levels, particularly when the menopause occurs before the age of 45, there is an increased risk of progressive loss of bone strength leading to bone thinning and fragility (osteoporosis).
Women can lose up to 20 per cent of their bone density in the five to seven years after menopause. “Development of osteoporosis in women is influenced by the strength of the bones before the menopause (peak bone mass being achieved in the 20s and being influenced by weight bearing exercise, diet adequate in calcium and vitamin D and by genetic influences), the age of menopause and the rate of bone loss with menopause and age,” explains Dr Currie, founder of Menopause Matters and an associate specialist gynaecologist and obstetrician at Dumfries and Galloway Royal Infirmary.
Although the menopause can affect your bone density, this is not the only factor in osteoporosis. However, it’s important that you consider your lifestyle during the menopause, and make sure you are doing everything to protect your bone health.
A healthy diet and lifestyle are very important not only at menopause, but also in early years to maintain your bone strength. The best thing for your bones is weight-bearing exercise, the type that involves putting force through your bones. This includes activities such as walking, jogging, running, tennis and aerobics. Try and find an activity that you enjoy, and make simple changes to your daily routine, such as walking to the shops to buy a paper, rather than having it delivered, and taking the stairs, rather than a lift.
“Eat a well-balanced diet, with plenty of calcium and vitamin D,” advises Dr Currie. Calcium is the main nutrient required for strong bones, so incorporating foods which are rich in calcium is essential. Aim for around 700mg calcium daily, which is the equivalent of a pint of semi-skimmed milk per day. Other sources are: oily fish, green leafy vegetables, bread, cereals, dried fruit, pulses, beans and seeds. With a balanced diet, you shouldn’t need to supplement calcium.
An adequate intake of vitamin D is also required for calcium to be absorbed properly. Good dietary sources of vitamin D include dairy products, oily fish, fortified margarine and eggs, however most of our vitamin D comes from the action of sunlight on the skin. “There is some debate around the need for vitamin D supplements in the UK, where we don't get enough sunshine over the winter months,” says Dr Currie.