Menopause increases the risk of fractures in women, largely due to a decline in bone mineral density, otherwise known as bone loss.
While the effects of postmenopausal bone loss are well known, less is understood about how bone changes during and directly after the menopausal transition. Understanding this phase is important, as it may shape long-term fracture risk and help inform treatment decisions.
Dr Kara Holloway-Kew from Deakin University’s Institute for Mental and Physical Health and Clinical Translation (IMPACT) aims to better understand how the early stage of menopause affects women’s bones.
Drawing on data from the Geelong Osteoporosis Study, a collaborative project between Deakin University and Barwon Health, Dr Holloway-Kew analysed bone mineral density for 287 women who reported recent menopause.
The findings build on existing research by improving our understanding of how bone mineral density changes during menopause, and how patterns of bone loss contribute to future fracture risk.
Understanding menopause and bone loss
Dr Holloway-Kew found that the rate of bone loss was more pronounced during the first five years post-menopause, and that various factors impact these results.
‘Our research showed that women experienced significant bone loss across multiple skeletal sites, with the greatest change observed in the spine and wrist, compared to the hip and mid-forearm.’
‘Interestingly, women using hormone replacement therapy (HT) experienced a reduced amount of bone loss across all skeletal sites examined, she explains.
Reducing fracture risk during and after menopause
Dr Holloway-Kew says that identifying that bone loss occurs in early menopause means that better strategies can be developed and implemented sooner to improve outcomes for women as they age.
‘One in three women over 50 years experience a fracture in their remaining lifetime, with bone loss after menopause being a major contributing factor.’
In Australia certain medications such as bisphosphonates, to treat osteoporosis, are only subsidised under specific conditions, including being aged 70 years or over and having a confirmed diagnosis of osteoporosis
‘By the time an individual meets the criteria, they may have already experienced substantial bone loss and sustained one or more fractures.’
‘We need to shift the goal posts to ensure better access to early interventions that reduce fractures and improve quality of life,’ she says.
What’s next for menopause and bone health research?
Dr Holloway-Kew’s future research will transfer focus from bone loss to fractures, with upcoming studies exploring how changes in bone during and shortly after menopause relate to fracture risk.
By investigating bone measurements at different skeletal sites, the research aims to identify those at highest risk and inform targeted prevention strategies.
