50 plus? Take care of your bones

Osteoarthritis, more common among women, increases multi-fold after menopause


Transformation from an adolescent to a teenager, and from a teenager to a woman, leads to various biological, hormonal and psychological changes. The menstruation cycle is a natural and physiological process, and an integral part of a woman’s life. This process essentially allows her to bring a new life into this world. Yet, menopause, in many ways, can be a welcome change—no more menstrual cramps, frequent mood swings or headaches.

Globally, women experience menopause between the ages of 45-55 years. However, a recent survey conducted by The Institute for Social and Economic Change states that about four per cent of Indian women experience menopause between the age of 29-34, and approximately eight per cent in the 35-39 age group. This is largely because of differences in lifestyle.

Menopause and healthy bones

Estrogen, a hormone found in both men and women, plays a vital role in promoting the activity of osteoblasts, cells that are bone-forming. During menopause, the estrogen levels in women drop, thereby limiting the efficiency of the osteoblasts. As a result, the bones become weaker than in men. Less estrogen reduces calcium absorption, thus decreasing bone density, and causing reduction in overall bone mass. This pre-disposes women to a higher risk of orthopaedic ailments like osteoporosis and osteoarthritis (OA).

To be aware of one’s health and to equip oneself with the right knowledge, right decisions have to be made with regards to prevention and cure of these conditions.

OA is not a disease but a condition, which occurs as a result of the regular wear and tear of joints. Every human being experiences it at some point in their lives. However, if this progresses, it can become a challenge, and impact one’s quality of life, impacting the mobility of joints at a later stage.

Why are young women falling prey to early menopause?

The common reasons for early menopause can vary from smoking, pre-existing thyroid disorders, to chemotherapy and major pelvic surgeries. Staying indoors for long, leading a sedentary lifestyle, body-weight problems, and calcium deficiency can add to the risk of osteoarthritis. Aches, stiffness and swelling around the joint, and, sometimes a warm joint, are typical symptoms of menopausal joint pain. These may worsen during the morning, and subside as the day continues.

Treating OA

Researchers have observed that OA is more common among women than men, and its risk increases multi-fold after menopause, even if they are on hormone-replacement therapy (wherein the natural estrogen loss is supplemented through medication).

In the primary stages, OA is usually treated with pain killers. While painkillers help subside the pain, exercise helps in strengthening the muscles around the joints, that eventually stabilises and protects the joint from further damage. In chronic arthritis, where the condition becomes severe enough to affect one’s mobility and quality of life, replacing the damaged joint may be the most viable option. In joint replacement surgeries, the damaged part of the joint surface is removed, and resurfaced to accommodate the artificial implant. This new implant helps to relieve pain and restores smooth functioning of the joint.

A study conducted at the University of Bremen in Germany found that those who undergo a total knee replacement (TKR) for osteoarthritis of the knee are much more physically active within a year of surgery. It was also noted that a TKR offers profound improvement in the level of physical activity of most patients.

Prevention is better than cure

Hormone levels change in both men and women. In women, it is referred to as menopause; whereas in men, when their testosterone levels begin to drop, it is called andropause. Bone loss among women happens at the average rate of 2-3 per cent a year, while among men, it is only 0.4 per cent of the bone mass. Knowing what your body needs can help in keeping your bones and joints healthy, and away from severe joint conditions.

While the loss cannot be entirely prevented, there are ways to reduce the rate of loss through anti-osteoporotic treatment replacement therapy. Regular exercise, weight training, consumption of protein and calcium rich food, avoiding caffeine and reducing the intake of tea and aerated drinks, can go a long way in keeping the joints healthy.

DrTalwar is associate professor and joint replacement surgeon at Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital.

Dr Bhardwaj is chief of knee and hip replacement and arthroscopy department at the Pushpawati Singhania Research Institute Hospital.