The most important long-term effect of reduced estrogen involves the effects on the skeleton. With age and reduced estrogen 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). Bone loss affects both men and women as they age but the loss occurs much more rapidly in women so that osteoporosis is much commoner in women than men.
Osteoporosis is defined as: a systemic skeletal disease characterised by low bone mass and microarchitectural deterioraton of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.
Bone loss itself does not cause any symptoms until a fracture occurs, often as a result of a simple fall. Fractures commonly occur in the wrist, spine and hip. Such fractures can significantly reduce quality of life, independence and, in the case of hip fracture, can shorten life. It has recently been estimated that by the age of 70, one in two of all women and one in five men will have had a fracture related to osteoporosis and that the number of hip fractures worldwide will increase further in the future. Development of osteoporosis in women is influenced by the strength of the bones before the menopause (peak bone mass being achieved in the twenties 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.
Fracture Risk Assessment Tools
FRAX: Calculate your ten year probability of fracture with Bone Mineral Density
Q Fracture: Calculator to work out your risk of developing any osteoporotic fracture
PDF 359kb, 8 pages, added 1 March 2011
Advice for Healthy Bones
PDF 89kb, 4 pages, added 1 March 2011