Osteoporosis in Menopause

What it is

Osteoporosis is the decrease in bone mass and quality, making bones more fragile and prone to fractures, mainly of the wrist, spine and hip. In women, bone loss accelerates in the first years after menopause, as estrogen levels drop; family history, low body weight, smoking, a sedentary lifestyle, prolonged corticosteroid use and early menopause increase the risk. The condition is silent until the first fracture, which is why prevention and screening are essential. The assessment includes a bone density scan, blood tests such as calcium and vitamin D, and analysis of risk factors. Treatment combines a calcium-rich diet, vitamin D supplementation, weight-bearing exercise, fall prevention and, when indicated, menopausal hormone therapy or specific bone medications, with periodic follow-up.

Most common symptoms

• No symptoms until the first fracture
• Fractures from minor falls, in the wrist, spine or hip
• Persistent back pain, from microfractures in the vertebrae
• Loss of height over the years
• Stooped posture or increased curvature of the spine
• An abnormal bone density scan found on routine testing

Causes and risk factors

• Drop in estrogen in the first years after menopause
• Premature menopause or removal of the ovaries
• Family history of osteoporosis or hip fracture
• Low body weight, a sedentary lifestyle, smoking and excessive alcohol use
• Prolonged corticosteroid use and certain thyroid diseases
• Low calcium intake and vitamin D deficiency

How it is diagnosed

The assessment begins with the clinical history and risk factors: age at menopause, family history, previous fractures, medications, diet, physical activity and habits. The main test is the bone density scan, which measures bone mass in the spine and hip and classifies the result as normal, osteopenia or osteoporosis. Blood tests, such as calcium, vitamin D, kidney and thyroid function, help identify secondary causes. Your gynecologist estimates fracture risk and determines how often follow-up is needed.

How we treat it at Femi Saúde

Prevention and treatment go hand in hand. The gynecology team at Femi Saúde guides a calcium-rich diet, adequate sun exposure and vitamin D supplementation when levels are low, along with weight-bearing and balance exercises and fall-prevention measures. In women with symptoms of perimenopause or premature menopause, hormone therapy may be indicated, with benefits for the bones as well. When osteoporosis is established or fracture risk is high, specific bone medications are prescribed according to each patient's profile, and the response is monitored with periodic bone density scans. The plan is individualized and reviewed over time.

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