Women's Health Research Institute

The risk of osteoporosis and osteopenia (lower than normal bone mineral density) increases as we age, with women being more likely to suffer from low bone mass than men, and menopausal women being a particularly vulnerable population due to drastic hormonal changes. Recently, Swedish researchers studied a group of European women and found that early menopause (defined as the onset of menopause before the age of 47) may be associated with an increased risk of bone fracture and osteoporosis.

Researchers controlled for factors such as calcium intake, age, smoking, and body mass index, and took bone mineral density (BMD) measures from the forearms of 390 women. At the beginning of the study, all women were 48 years old. Researchers divided women into an ‘early menopause’ (those with an onset before age 47) and a ‘late menopause’ (onset at age 47 or later) group, and followed up with a second BMD measure at age 77. Women who reached menopause before the age of 48 had nearly an 80% increased risk of osteoporosis, a 68% increased risk of bone fracture, and a 60% increased risk of death compared to women who started menopause after age 48.

Although the results are compelling, a causal relationship between early menopause and increased risk of osteoporosis and fracture cannot be confirmed. “The reason for the higher fracture risk among women with early menopause can only be speculated upon,” stated the authors. Subsequent research is needed to determine whether or not physiological changes associated with early menopause cause an increase in BMD, or if other factors are at play.

This study succeeds in the 97% participation rate, the use of participants of the same age and ethnicity, and length of the study, but is limited in that the overall findings cannot be fully explained by low BMD and that mortality risk was not considered in light of other factors such as nutritional intake, other diseases, and lifestyle factors.

Dr. Svejme, the lead author, suggested that menopausal women “should have bone density measurements taken int he first decade after menopause.” For women entering menopause prior to age 48, early screening may be even more beneficial in light of these study results. Other preventative measures to protect against bone loss include regular exercise (which may delay bone loss in premenopausal women), sufficient calcium and vitamin D intake (1000 milligrams of calcium and 600 international units of vitamin D per day are the general recommendations), and smoking cessation (smoking has been associated with an increased rate of bone loss).