Menopause (cont.)
What are the complications and effects of menopause on chronic medical conditions?
Osteoporosis
Osteoporosis is the deterioration of the quantity and
quality of bone that causes an increased risk of fracture. The density of the bone (bone mineral
density) normally begins to decrease in women during the fourth decade of life.
However, that normal decline in bone density is accelerated during the
menopausal transition. As a consequence, both age and the hormonal changes due
to the menopause transition act together to cause osteoporosis.
The process leading to osteoporosis can operate silently for decades. Women
may not be aware of their osteoporosis until suffering a painful fracture. The
symptoms are then related to the location and severity of the fractures.
Treatment of osteoporosis
The goal of osteoporosis treatment is the prevention of bone fractures by
slowing bone loss and increasing bone density and strength. Although early
detection and timely treatment of osteoporosis can substantially decrease the
risk of future fracture, none of the available treatments for osteoporosis are
complete cures for the condition. Therefore, the prevention of osteoporosis is
as important as treatment. Osteoporosis treatment and prevention measures are:
- Lifestyle changes including cessation of cigarette
smoking, curtailing alcohol intake, exercising regularly, and consuming a balanced diet with
adequate calcium and
vitamin D.
- Calcium and vitamin D supplements may be recommended for women who do not consume sufficient quantities of these nutrients.
- Medications that stop bone loss and increase bone
strength include alendronate (Fosamax),
risedronate (Actonel),
ibandronate
(Boniva), zoledronic acid
(Reclast), raloxifene (Evista), and
calcitonin (Calcimar).
Teriparatide (Forteo)
is a medication that
increases bone formation.
Cardiovascular disease
Prior to menopause, women have a decreased risk of
heart disease and
stroke when compared with men. Around the time of menopause, however, a women's
risk of cardiovascular disease increases. Heart disease is the leading cause of death
in both men and women in the U.S.
Coronary heart disease rates in postmenopausal women are
two to three times higher than in women of the same age who have not reached menopause.
This increased risk for cardiovascular disease may be related to declining
estrogen levels, but in light of other factors (see Treatment section below),
postmenopausal women are not advised to take hormone therapy simply as a
preventive measure to decrease their risk of heart attack or stroke.
Next: Are hormone levels or other blood tests helpful in detecting menopause? »
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