The link between menopause and osteoporosis, as new drug approved

Kate Ng
·Trending Lifestyle Reporter
·3-min read
Senior woman having problems with hip pain while standing in living room at home.
Postmenopausal women are particularly at risk of fractures due to osteoporosis. (Getty Images)

Women’s bodies undergo numerous changes throughout their lives, with menopause bringing about some of the most significant changes after puberty.

Awareness about just how much menopause can affect women’s physical and mental health has risen over recent years. This stage of life doesn’t just mean the end of menstruation, but it can also leave a lasting impact on women’s bones, muscles, and overall wellbeing.

During perimenopause (the period before menopause begins) and menopause, the female sex hormone oestrogen declines. This hormone is crucial for maintaining bone density and bone strength, and the drop in oestrogen levels causes bone density to decline as well.

This means that women who are going through or have gone through menopause are at much higher risk of developing osteoporosis, a condition that weakens bones and makes them prone to fractures and breaks.

According to the Endocrine Society, one in two postmenopausal women will have osteoporosis. It points to research showing that up to 20% of bone loss can happen during menopause and post-menopausal stages, with approximately one in 10 women over the age of 60 being affected by osteoporosis globally.

Well, here comes old age
Wrist fractures are one of the most common bone breaks experienced by people with osteoporosis. (Getty Images)

The most common injuries experienced by people with osteoporosis include broken wrist, broken hip (hip fracture), and broken spinal bones.

However, breaks can occur in other places, the NHS says, including in the arm or pelvis. Sometimes coughing or sneezing can be forceful enough to cause a broken rib or partial collapse of one of the bones in the spine.

Fractures can have a significant impact on everyday life and affect a person’s independence. They are also associated with increased mortality, says the National Institute for Health and Care Excellence (NICE).

It added that "people with osteoporosis live in fear of having another fracture", leading them to become "anxious and withdrawn".

"They said they have difficulty doing day-to-day tasks and can no longer do some things they previously enjoyed, such as going for walks. It can also hinder their ability to care for others, such as their partners."

Given women are much more likely to be caregivers compared to men - with figures from the Office for National Statistics showing that the percentage of people providing unpaid care is higher in women than men in England and Wales - the impact of osteoporosis on those who are postmenopausal can have a significantly negative effect on their quality of life.

Hormone replacement therapy (HRT) is usually considered the most appropriate treatment for osteoporosis, according to the Royal Osteoporosis Society. HRT helps alleviate symptoms of menopause by replacing the female hormones that have declined during this stage.

However, on Wednesday 7 August, NICE announced that a new bone-strengthening drug will become available for postmenopausal women on the NHS in England within the next three months.

The drug, Abaloparatide, can help protect women against osteoporosis, the medicines watchdog said. It comes as an injection in a pre-filled pen that people can self-administer at home once a day.

Dr Nicky Peel, a clinical trustee at the Royal Osteoporosis Society, told BBC Radio 4’s Today programme that the new medicine is "very well tolerated" by most people - although some patients can experience side effects like nausea, headaches and palpitations in the early stages of treatment.

Nevertheless, Abaloparatide is suitable for most people who are at very high risk of fractures. The approval of the drug, made by Theramex, is expected to benefit over 14,000 women.

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