Your Ultimate Guide to Menopause and its Effect On Your Bones

Premenopause

Premenopause starts when an adolescent girl enters her reproductive years and ends with the first signs of menopause, which usually begin to appear between the ages of 48-52.

Perimenopause

Literally means “around menopause.” It’s also referred to as the “menopausal transition.”

This is the time when a woman’s body begins to shift from regular ovulation cycles and a monthly menstrual period to menopausal symptoms that may include: hot flashes, night sweats, infertility, vaginal dryness, and absence of menstruation. Women typically begin to experience this stage in their mid-40s.

Early or “Premature” Menopause

In the U.S., the average age for “natural” menopause is 52 years old. However, due to illness, smoking, medical procedures or genetics, some women may go through menopause early. Early menopause refers to onset before age 40. There are several known causes of early menopause, including:

• Genetics: If your mother or grandmother went through menopause early, you may have an increased chance of the same.
• Chromosome Defects: Two functioning chromosomes appear to be necessary for normal ovarian function. In a rare genetic condition called Turner Syndrome, the loss of the complete or near-complete second X chromosome occurs. This causes the ovaries to not function properly and typically leads to early menopause.
• Smoking: Smoking has anti-estrogen effects and promotes early menopause.
• Being too thin: Estrogen is stored in your fat tissues, so if you’re overly thin, you have fewer estrogen stores. Women who have a very low Body Mass Index (BMI) may be at risk of early menopause.
• Excessive exercise or lack of exercise: Some research suggests that either may promote early menopause.
• Excessive sun exposure or a lack of sun exposure: Again, some research suggests either may contribute to early menopause.
• Autoimmune diseases: Inflammation caused by autoimmune diseases can affect the ovaries. Early menopause can be a symptom of rheumatoid arthritis or thyroid disease.
• Epilepsy: Women with this seizure disorder that stems from the brain are more likely to experience early menopause. One study published in the journal Epilepsia found that women with epilepsy had an increased risk of developing premature ovarian failure.
• Procedures: A hysterectomy (removal of all or portion of the uterus) and/or an oophorectomy (removal of ovaries) will lead to early menopause.
• Treatments: Chemotherapy, hormone therapies, radiation and cancer treatments can contribute to early menopause.

While premature menopause is usually the result of one or more of the causes above, it can also occur naturally in some cases. Premature menopause symptoms are typically the same as natural menopause symptoms.

Menopause

This is the conclusion of the natural transition in a woman’s reproductive life. It’s the point where progesterone and estrogen production decrease permanently to low levels. The ovaries stop producing eggs, and a woman is no longer able to become pregnant, naturally. Menopause is officially marked by the total cessation of the menstrual cycle for 12 months or more. In other words, not having a period for at least 12 months in a row.

On average, menopause occurs around age 52 in the United States but varies from woman to woman.

Menopause-associated symptoms may never occur or can last for several months or even years, depending on the individual. With the exception of irregular periods, all the following common signs and symptoms can be prevented or effectively treated, naturally:

• Irregular Periods
• Vaginal Dryness
• Loss of Libido
• Hot Flashes
• Insomnia
• Urinary Incontinence
• Mood Changes
• Memory and Cognitive Function
• Hair Loss
• Decreased Breast Fullness
• Skin Issues
• Weight Gain
• Bone Loss

For a more in-depth and expanded version of menopause symptoms, check out: 13 Common Signs and Symptoms of Menopause.

Postmenopause

These are the years after menopause. From here on, a woman is postmenopausal for the rest of her life. A woman is considered postmenopausal when she has not had a menstrual period for a full year (12 months).

If you’re concerned about the possibility of an unwanted pregnancy, you can confirm you’re postmenopausal with a blood test called the follicle stimulating hormone (FSH) test. When a woman’s FSH level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it’s generally accepted that she has reached menopause. However, using this test is not routine or needed for the vast majority of women.

The symptoms that began in perimenopause may continue past menopause, and without taking steps to support youthful function, many of them will remain.

Due to the significant decrease in estrogen and progesterone production, and the resulting increase in susceptibility to chronic inflammation, after menopause, women must take extra self-care steps to reduce our increased risk for heart disease and bone loss.

That’s why an anti-inflammatory lifestyle that includes regular, weight-bearing physical activity and an anti-inflammatory diet, along with key supplements that lower inflammation and ensure nutrient needs are fully met, become more important than ever.

Hormonal Fluctuations

Hormones regulate the activity of cells and tissues in your organs. It’s essential that your body produces balanced hormones for overall health and well-being. However, during menopause, your fracture risk increases due to extreme hormonal changes. Why? These hormone changes disrupt your body’s natural bone-building process.

Estrogen, progesterone, and testosterone are hormones produced by the ovaries. The production of these three hormones changes and fluctuates during your mid-life years and can increase your risk of bone loss.

Hormones During Menopause

• Estrogen plays an important role in the regulation of bone turnover. During menopause, the ovaries decrease the production of estrogen. Estrogen deficiency can induce cortical (hard outer shell of the bone) and trabecular (spongy inside) bone loss. This increase in bone resorption can lead to the destruction of bone architecture, bone loss, and microfractures. Estrogen and calcium also have a relationship when it comes to bone health. Estrogen supports intestinal absorption of calcium. So having low estrogen levels can negatively impact the amount of calcium you’re able to absorb.
• Progesterone, like estrogen, plays an important role in bone turnover and bone formation. Because osteoporosis is primarily considered a result of estrogen deficiency, less emphasis has been placed on progesterone. But in reality, one of the three estrogens works together with progesterone in every tissue of a woman’s normal physiology. In vitro studies in human osteoblasts indicate that progesterone is likely working through bone formation pathways, meaning it plays an active role in osteoporosis prevention and bone health. While estrogen is still a dominant focus for osteoporosis in menopausal women, progesterone is emerging as a potentially important hormone partner.
• Testosterone has anabolic (muscle growth and development of muscles) and androgenic (sexual characteristics such as libido, mood, sex drive etc.) effects. These effects are crucial for both men and women (even though men produce significantly more testosterone than women). Human studies show that estrogen is needed for suppressing bone resorption, but both androgen and estrogen are crucial for bone formation.

These inevitable changes in your hormones during menopause can significantly affect your bone health. To combat this bone loss due to hormonal changes, you may need to increase your nutrient intake.

Nutrient Needs Change

As hormone levels diminish during menopause, bone loss may occur and contribute to weak and brittle bones. As discussed, one of the ways in which estrogen supports bone health is by aiding in the absorption of calcium in your intestine. So, ensuring you’re getting an adequate amount of calcium along with the other key vitamins and minerals that assist in its absorption is crucial.

For women 51 years and older, that means getting 1,200 mg of calcium from all sources (food and supplements) each day. Combining calcium with magnesium, vitamin D3, vitamin K2, boron and trace minerals will ensure that your bones are getting all the nutrients they need. But don’t forget about the omega 3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They have been shown to reduce the risk of cognitive decline and cardiovascular disease, and also play a role in protecting your bones. They do this by lessening inflammation. And anything that causes inflammation activates osteoclasts, the cells that break down bone.

As an emphasis on nutrient needs is heightened during menopause, it’s important to ensure you’re getting enough of the right nutrients by supplementing with a clinically supported bone-building supplement and a one-of-a-kind fish oil.

Lack of Sleep and Stress

Insomnia occurs in 40-50% of women during menopause. And problems with a good night’s rest may or may not be connected to mood disorders. Women with insomnia are more likely than others to report tension, depressive symptoms, anxiety, and stress.

A 2005 study published in Clinical Calcium discussed three ways in which stress and bone health are related.

1. Stress induces physiological changes leading to osteoporosis. When your body is stressed, it releases a steroid hormone called cortisol. Cortisol indirectly acts on bone by blocking calcium absorption, which decreases bone cell growth. So when you’re stressed for even a short period of time, elevated cortisol may decrease bone mineral density. Stress increases the rate at which your body uses magnesium and your needs for this key bone health mineral.
2. Stress induces behavioral distortion of drinking, eating, sleep habits, and exercise that can lead to osteoporosis. Stress can cause insomnia, making it difficult for you to reach the 6-8 hours of sleep you need each night. And for some, it can affect their food, drink, and exercise choices. Harvard Health suggests there is much truth behind “stress eating”. Stress tends to push people towards consuming high-sugar and high-fat foods! Again, this is due to high cortisol levels or a combination of high cortisol and high insulin levels.
3. Osteoporosis, on the other hand, can lead to depression, social isolation and stress. If you find yourself in menopausal transition and discover you also have bone loss or osteoporosis…it can be a lot to handle. You may feel stressed, anxious, and lonely. However, know you’re not alone in this journey. There are women just like you currently struggling through similar situations or who have gone through these experiences, and are sharing their success stories with AlgaeCal and its community. We at AlgaeCal encourage the conversation and sharing of experience and information. With this knowledge, you can take your health and life into your own, well-informed hands. If you have any questions or simply want to connect with others like you, comment at the end of this post.

The reality is, approximately 40% of all postmenopausal women will eventually experience a fracture. But, you don’t have to be one of them! Today, women have treatment options to consider.

Bio-identical Hormone Replacement Therapy (BHRT)

BHRT is used to ease menopause symptoms with the goal of raising natural human hormone levels back to normal levels seen in women aged 35 years. The bio-identical human hormones used in BHRT are precisely identical in their biochemical structure to those women naturally produce. So, they function within our bodies like those a woman’s body produces on a daily basis. Therefore, our bodies can’t distinguish these supplemental hormones from those we produce ourselves. When your body sees bio-identical hormones, it welcomes back old friends and knows exactly what to do with them. And, when administered after thorough testing and monitored properly, BHRT hasn’t been found to produce adverse side-effects.

A personal note: Around age 50, I began to notice some changes in my menstrual cycling — more frequent periods and spotting. After running comprehensive hormone tests to get a baseline on my perimenopausal hormone levels, I was prescribed BHRT. I sailed through menopause at age 52 with nary a single symptom.

I’m almost 69 now and have been on BHRT since age 52 with annual testing to ensure my dosages of Bi-est and progesterone are correct for me. My health is excellent in every respect; I feel just as vibrant today as I did at age 35. BHRT is definitely a part of my bone health regimen, but only one part. Like everyone else’s bones, mine won’t maintain themselves healthfully without an optimal supply of all the key nutrients our bones require. Plus I also have a number of genetic susceptibilities for low bone density that BHRT doesn’t address. These, I have identified and corrected through a healthy diet and nutritional supplements, of which the most important for me are AlgaeCal Plus, Strontium Boost, and Triple Power.

For more information on BHRT, read Dr. Jonathan Wright, MD’s most recent book on the topic, Stay Young & Sexy with Bio-identical Hormone Replacement. Don’t be put off by the title. This book provides an easily understandable, and surprisingly entertaining review of virtually all the major studies done over the last 40+ years.

A number of organizations can help you locate a physician knowledgeable about BHRT. All are listed along with their contact information in Stay Young & Sexy with Bio-Identical Hormone Replacement. They include the American College for Advancement in Medicine, the International College of Integrative Medicine, and the American Academy of Environmental Medicine and Women in Balance.

Lifestyle Changes

The choices you make impact the way you feel. For example, smokers have lower levels of estrogen than non-smokers and are more likely to experience hot flashes more frequently than non-smokers. And smoking greatly increases your risk for bone loss and fractures. If you’re currently smoking, please get the help you need to STOP!

Avoid Known Triggers

Hot and spicy foods, caffeine and alcohol may induce hot flashes and contribute to fatigue. If you notice certain foods or drinks trigger episodes, try to avoid them. Caffeine tolerance can vary from woman to woman, so if you know you’re sensitive, react to or are unable to detoxify caffeine efficiently, then it’s something you should consider cutting out. Try decaffeinated coffee instead. You may not even miss the caffeine. Same goes for spicy foods, as they mimic hot flashes by raising your core body temperature. In some cases, they can make you sweat. If you love spicy food, you can still include it in your diet, but do try some spices with less heat as well. You may really enjoy the new flavors and avoid the hot flash effects on your body.

Acupuncture

Acupuncture can be a natural way to ease menopause symptoms. A small study published in 2011 showed that acupuncture was effective in reducing menopausal symptoms, including hot flashes. (That’s the case when compared to “sham treatments”, which are shallow needling procedures that don’t stimulate an acupuncture point.)

Exercise

Exercise can ease menopause symptoms. Multiple studies have shown that working out can reduce hot flashes and improve overall well-being, both mentally and physically. One study from the American College of Sports Medicine found that strength training reduced headaches and hot flashes by 50%! Another study published in The Journal of Physiology measured the characteristic of hot flashes and the impact of exercise with a gym-based program for 16 weeks. While one group undertook this program, the other group made no changes to their daily routine. The exercise group reported reduced symptoms of hot flashes, including less sweating when hot flashes did occur, and decreased arterial pressure.

Vitamin D

You probably know how we derive Vitamin D from the sun. It’s a natural, easy way to get this vital nutrient through our skin. As we age, however, our body becomes less efficient at converting the sun’s rays into the Vitamin D we need.

In fact, a 70-year-old makes 4 times less vitamin D from the sun than a 20-year-old. So it’s important we help our bodies by using dietary supplements. What’s more, vitamin D is a crucial ingredient to healthy bones.

Vitamin D is also linked to a reduced risk of several health issues like: osteoporosis, high blood pressure, heart attacks, asthma, and strokes, among others.

An updated study from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) found Vitamin D gives a big boost to menopausal women as well. ESCEO found having blood levels of 20 ng/mL or less promotes “increased bone turnover, bone loss, and possibly mineralization defects.” That’s in comparison to those with blood levels above that amount.

Instead of guessing how much vitamin D you need, it’s best to be sure and get a vitamin D test.

Either ask your doctor to order this test for you (it should be covered by your insurance) or check out the Vitamin D Council as they have an easy finger-prick mail in test kit you can use. Know your levels, then supplement accordingly!

Magnesium

 Another “must” for healthy bones. Magnesium is one of the 13 minerals your bones require to stay strong and functional every day. But do you know the surprising link between magnesium and menopause?

One interesting study came from the Virginia University Health System. It found magnesium supplements can reduce the frequency of hot flashes!

Scientists had 25 women with an average age of 53.5 take magnesium over a 4-week period. They found the majority had a large reduction in hot flashes– from a previous average of 52, down to only 28 per week–  for a 41% improvement.

Fatigue, sweating, and distress were also significantly reduced.

And guess what… dark chocolate is a really good source of magnesium! How’s that for a little menopause “secret weapon”?

Calcium

Calcium is the most “common” mineral folks mention when it comes to bone health. And it’s even more critical when we’re talking about menopause.

Because of the drop in estrogen, we also experience a decrease in our ability to absorb, efficiently use and retain calcium during menopause. The loss of estrogen lessens the body’s ability to absorb calcium from our diet. That’s why calcium supplementation (preferably from plant sources) is always advised as we age to ensure optimal amounts of calcium.

And in addition to being a catalyst for strong, healthy bones, calcium can also have positive effects on other unrelated disorders. Things like: high blood pressure, colorectal cancer, obesity, and kidney stone formation.

So together, vitamin D, magnesium, and calcium form the “menopause trifecta” that can help you age gracefully and much more comfortably. They can ease menopause symptoms while also keeping you strong and mobile while they’re at it!

However, supplementing with all three nutrients separately can be irksome. For one, it’s expensive. Two, you must remember to take them and refill your supply– often at different times. And you must ensure you take the right kinds (and amounts) of each!