In the past 25 years various social and economic changes have resulted in a major alteration of the role of women in society. In tandem with these changes has been the emergence of improved health care services for women. Consequently women are now living an average 25–30 years after the menopause. The quality of life during these years is an important and sometimes neglected issue. Fortunately most women are now becoming more conscious of health issues generally, and of the need to keep physically and mentally healthy in order to enjoy the later years of their lives.
Osteoporosis represents one of the more serious health risks affecting women after the menopause. Most Irish women will experience the menopause between the ages of 45–55 years. During this time there is a decline in the production of the hormone oestrogen by the ovaries. Oestrogen is an important hormone, which has a number of functions in the body. One of these functions is to keep bones strong and healthy. As many women can now expect to live well into their 80s there is in the post menopausal years an increased risk for several diseases associated with this decline in oestrogen levels. Osteoporosis is one of these diseases.
Osteoporosis is a thinning of bone associated with an increased risk of fractures, bone pain and bone deformity in severe cases. Before the menopause oestrogen plays a significant role in maintaining strong and health bones. However after the menopause as oestrogen levels decline women become more at risk, so while osteoporosis can affect all women it is much more common after the age of 50 years. Osteoporosis develops slowly over time. Therefore many women may not be aware they are sufferers until they begin to experience bone pain and as time progresses develop brittle bones and loss of height. While it can affect any bone the most common sites of fracture due to osteoporosis are the spine, wrist and hip. Even moderate osteoporosis can have adverse affect on quality of life, impairing mobility and leisure activities. In severe cases fractures of the spine can lead to spinal curvature known in the lay terms as dowagers hump.
While some women are more at risk because of early menopause or family history, nevertheless there are a number of risk factors over which women have control. Simple lifestyle changes such as regular exercise, stopping smoking and ensuring an adequate dietary intake of calcium are helpful in preventing osteoporosis. Bone densitometry scanning is now easily available in the Galway area, and can be used to identify people who are at risk of developing osteoporosis, as well as those who have established disease. Your doctor will be able to arrange screening and subsequently discuss the findings with you. A treatment programme tailored to your individual needs can then be started.
Hormone replacement therapy is an effective treatment for all menopausal symptoms. It also helps prevent osteoporosis and heart disease. Not every woman can avail of HRT. Your doctor will advise you on your suitability and of the benefits and risks of this treatment option.
Like most health care issues awareness is the first step to prevention so be aware of the risks that you face. If you are unsure visit your doctor and discuss with him or her, the health risks more relevant to you. Do not be afraid to ask questions and if necessary prepare a list and take this with you when you visit your doctor. Try to start making simple changes yourself. For example, look at your current level of exercise and the quality of your diet and see how they can be improved. In addition consider screening for other conditions such as high cholesterol, cervical cancer, breast cancer and high blood pressure, and arrange to avail of current screening services in your area. If you don’t know where to start ask your doctor for information on the choices available to you.
Unfortunately many Irish women do not realise they are at risk from osteoporosis as well as other diseases more common in the menopausal years such as heart disease and breast cancer until it is too late. If you start in time you can greatly improve your chances of early detection and indeed of avoiding these diseases altogether through lifestyle changes, preventative health measures and screening. Taking responsibility now for your own health is the first step to ensuring a happy and healthy life in your later years.
Dr Mary Conroy