Therefore, women should pay attention to regular bone mineral density examination to prevent and improve osteoporosis when they enter the stage of irregular menstruation, menopause and postmenopausal.
What is osteoporosis? Osteoporosis refers to a systemic bone disease characterized by decreased bone mass, destroyed bone microstructure, increased bone brittleness and fracture, in which the calcium loss rate of our human bones is accelerated, and the bone formation rate is lower than the bone absorption rate, resulting in decreased bone density. In fact, osteoporosis is literally well understood, that is, the density of our originally dense and strong bones has decreased, and it is not so strong. Figuratively speaking, the small hole in the bone, which was originally tight, has now become bigger and looser, which is more likely to cause fracture problems.
However, due to the great decrease of estrogen level in menopause and postmenopausal women, the protective effect of estrogen on bone mineral density will gradually decrease, which will lead to accelerated bone loss and make menopausal women more susceptible to osteoporosis. According to a set of statistics, before the age of 35, the fracture ratio between women and men was 1: 1, while among the elderly aged around 60, the forearm fracture rate of women was about 10 times that of men. Therefore, it is very important for menopausal female friends to do a good job in the investigation and prevention of osteoporosis and actively adjust and intervene osteoporosis.
It is generally recommended that menopausal women have regular bone mineral density examination to confirm whether there is osteoporosis, especially those female friends who have symptoms of bone pain during menopause and postmenopausal, whose diet is mainly vegetarian and do not drink milk, should pay more attention to the investigation. In this case, if there is no reasonable nutritional supplement and improvement, the probability of osteoporosis is very high.
In order to prevent and improve osteoporosis in menopausal and postmenopausal women, everyone knows that calcium should be supplemented, but at the same time, vitamin D should also be supplemented. Generally speaking, for menopausal women, if osteoporosis has not yet occurred, the daily intake of calcium and vitamin D should be around 1000mg and 800IU. For friends who already have osteoporosis problems, American guidelines for diagnosis and treatment of postmenopausal osteoporosis 20 16 recommend that the daily calcium supplement should be no less than 1200mg, and the daily intake of vitamin D3 should reach 1000~2000IU. Only when the concentration of serum 25(OH)D is more than 30μg/L can help to improve osteoporosis.
Middle-aged and elderly female friends who have been diagnosed with osteoporosis should take medicine under the guidance of doctors to control osteoporosis, in addition to supplementing calcium and vitamin D. At present, the most commonly used and preferred drugs are bone resorption inhibitors, such as zoledronic acid, alendronate sodium, leredronic acid and so on. However, it should be noted that these drugs generally need to be taken for a long time (3-5 years) and often have certain stomach irritation. For friends with bad stomach, besides bone resorption inhibitors, you can also consider taking estrogen preparations such as raloxifene to improve osteoporosis caused by bone loss in the body. These drugs can be used as female friends with osteoporosis, which has a high risk of spinal fracture, but there is no risk of hip and non-spinal fracture.
At present, there are some new drugs to treat osteoporosis, such as dinol and teriparatide. These drugs have novel mechanisms of action and have good therapeutic effects on osteoporosis and bone pain, but they are often expensive and cannot be widely used as first-line drugs at present. You can ask a doctor to determine whether you need to use these drugs to treat osteoporosis after comprehensive evaluation according to your physical condition and economic situation.
Anti-osteoporosis drugs are only a preliminary introduction, and ultimately we should formulate specific medication plans in light of our own situation. After medication, let's talk about the daily precautions of osteoporosis, which is also indispensable for menopausal women to prevent osteoporosis. Generally speaking, menopausal women are advised to drink as little as possible, and it is best not to drink. At the same time, they should avoid smoking and breathing secondhand smoke. In diet, we should pay attention to the nutritional balance of calcium and vitamin D supplementation; Strengthening physical exercise is also an important aspect of preventing and improving postmenopausal osteoporosis in women. On the one hand, we should pay attention to controlling the intensity of exercise and reducing the risk of fracture. On the other hand, under the condition of reasonable arrangement of exercise intensity, strengthening resistance exercise, weight bearing and balanced exercise is beneficial to improve osteoporosis, improve muscle strength and reduce the incidence of musculoskeletal pain. In addition, it is also necessary to pay attention to, that is, we must pay attention to avoid the risk of falling, and pay more attention to prevent slipping and falling in daily life, so as to better avoid the risk of fracture.
First, the reason why women are prone to osteoporosis after menopause: 1. Decreased estrogen secretion leads to decreased calcium absorption. 2. Insufficient calcium intake.
Second, the treatment of osteoporosis generally includes:
1. moderate exercise. Postmenopausal women should exercise for 3 hours a week, so it is not advisable to exercise excessively. If excessive exercise leads to amenorrhea, bone loss will accelerate.
2. Nutrients to prevent osteoporosis: including adequate calcium, vitamin D, vitamin C and protein. It is suggested that the calcium intake is 800 1000 mg for adults and 1000 1500 mg for postmenopausal women. The intake of vitamin D is 400-800 u/ day.
3. Drug therapy Effective drug therapy can prevent and treat osteoporosis, including estrogen replacement therapy, such as decreased estrogen secretion, and oral drug supplementation (estradiol).
The treatment of osteoporosis is particularly slow, so it is necessary to strengthen prevention and prevent the occurrence of osteoporosis, such as reasonable diet, no partial eclipse, reasonable dietary nutrition, and eat more foods containing calcium and phosphorus, such as fish, shrimp, milk and eggs. Insist on physical exercise, get more sunshine, don't smoke, don't drink, drink less coffee, strong tea and carbonated drinks. And have bad living habits. For postmenopausal women, bone loss is accelerating, so bone density should be checked once a year and treated by a professional doctor regularly.
Postmenopausal woman, sitting on the ground with an improper chair, had a fracture and a "compression lumbar fracture". This is the disaster caused by osteoporosis. What should we do?
More than 1.50% of postmenopausal women suffer from osteoporosis. Why? Half of postmenopausal women suffer from osteoporosis, because postmenopausal ovarian failure leads to estrogen deficiency. Under normal circumstances, human bone synthesis and dissolution form a dynamic balance, osteoblasts carry out bone synthesis, osteoclasts promote bone dissolution and absorption, and estrogen inhibits bone dissolution and absorption, which increases bone synthesis. However, after menopause, estrogen decreased significantly, osteoblast activity increased, osteoclasts were active, and bone dissolution and absorption were greater than synthesis, which led to the rapid loss of bone calcium. The original solid bone density becomes smaller, the original dense holes become larger, looser and honeycomb-shaped, and the bone brittleness increases, which is easy to fracture.
2. The fracture caused by osteoporosis is most likely to occur in the vertebral body, and it is also the root of hunchback and shortening in the elderly. Why? The most common part is vertebral body, and the common part is lumbar compression fracture. The spine is the main tissue that constitutes the human spine, and it plays the role of supporting the trunk and bearing weight. Great men who have made great contributions to the country are all described as "the pillars of the country" or "the backbone of the country", which shows the importance of the backbone. After osteoporosis occurs in the vertebral body, the bearing capacity decreases, the vertebral body will gradually change from square to wedge, and the intervertebral disc and ligament connecting the vertebral body will also undergo degenerative diseases. The spine of elderly women with osteoporosis will become more and more curved and shorter. When the bone mass decreases by 20%, the risk of lumbar fracture is very high.
3. How to judge whether you have osteoporosis? Low back pain will occur when bone mass loss exceeds 10%. Postmenopausal women with low back and leg pain or no discomfort can be diagnosed with bone loss simply by screening osteoporosis and going to the orthopedic department of the hospital for bone mineral density and bone metabolism examination.
4. What should I do after osteoporosis? Osteoporosis is not terrible. Comprehensive intervention measures can effectively prevent the complications of osteoporosis.
Prevention and treatment of osteoporosis should be early. When you are young, do a good job of storing bone matrix, exercise more, eat a balanced diet, and supplement calcium properly to prepare for the decrease of bone matrix after menopause and reduce the degree of bone aging. The following preventive measures can be used for postmenopausal women.
Insist on physical exercise. Take the initiative to walk more than 6000 steps every day, do *** 150 minutes of moderate-intensity exercise three times a week, and properly carry out resistance exercise to enhance bone health. However, exercise should be done according to one's ability to avoid sports injuries.
Increase outdoor activities. Sunlight exposure increases the synthesis of vitamin D in the skin and contributes to the absorption of calcium.
Add foods high in calcium to the diet. Dairy products are the first choice, the daily dosage is more than 300g, and the calcium content of milk is per 100g 100, which is not the highest, but it is the easiest to absorb. In addition, nuts, sesame paste, shrimp skin sheep and so on contain higher calcium, but the absorption rate is worse than milk.
Bean products can be supplemented appropriately. Soybean isoflavone in soybean is similar to estrogen in structure, and has certain estrogen activity, which is beneficial to improve diseases. Such as soybean milk, bean curd, dried bean curd and other bean products.
Drug therapy. Vitamin D3 can be supplemented, calcium can be supplemented, estrogen replacement therapy can be performed, and zoledronic acid and other anti-osteoporosis drugs can be used. Specific drug usage and dosage, need to consult orthopedic and gynecological doctors.
Conclusion: Osteoporosis is a common disease in postmenopausal women, which is prone to vertebral fracture and is also the cause of hunchback and short stature after old age. Prevention and treatment should start at an early age. After the occurrence of osteoporosis, pay attention to strengthening exercise, paying attention to food supplement and taking medicine when necessary.
Menopause does lead to symptoms such as osteoporosis in women, which is a problem that older and older women must actively face and pay attention to. First, osteoporosis can easily lead to fractures, and second, the loss of osteoporosis leads to the decline of overall physical fitness, so we should actively deal with it.
So, what is menopause and how to deal with postmenopausal osteoporosis?
1. What kind of existence is menopause for women? First of all, what is menopause! Menopause refers to the permanent termination of female reproductive function and menstrual cycle.
Simply put, there will be no more menstrual situations that upset women, and we will bid farewell to menstruation completely.
In the female reproductive stage, the menstrual cycle is usually once a month, accompanied by ovarian ovulation, which occurs two weeks after the start of the menstrual cycle. In order to ensure the regularity of the cycle, the ovary needs to produce enough estrogen and progesterone. When women reach a certain age, the ovaries stop secreting estrogen and progesterone, which leads to menopause.
Within a few years before menopause, the level of estrogen and progesterone secreted by the ovary began to decrease obviously, menstrual cycle and ovulation decreased, and finally ovulation stopped, so there was no possibility of pregnancy.
It should be noted that women's last menstruation can only be determined after one year of menstruation cessation.
The menopausal age of women in China is 45-55 years old, with an average of about 48 years old. The age of menopause varies from person to person, some even pass menopause at the age of 40, and some are still in menopause at the age of 60.
Second, menopause, will there be symptoms? 1, menopause
Perimenopausal symptoms may not appear or be obvious, but may be mild, moderate and severe, and the symptoms may last for 6 months to 10 years, which varies from person to person and cannot be generalized.
Menstrual cycle disorder may be the earliest symptom of perimenopausal period. The typical pattern is that the menstrual cycle is shortened first and then extended, but any pattern is possible.
Hot flashes affect about 75% of women and usually start before menopause. Most hot flashes in women will last for more than one year, and more than half of them have recurrent hot flashes for more than five years.
Other symptoms of perimenopausal period include mood changes, depression, irritability and anxiety.
2. Postmenopausal
Postmenopausal symptoms are often mild, at least not as serious as perimenopausal symptoms.
However, menopausal complications caused by decreased estrogen will continue to affect health, such as osteoporosis.
In addition, there will be symptoms such as vaginal dryness, decreased elasticity, dry skin and thinning.
Third, will menopause lead to osteoporosis? How to deal with it? The answer is yes!
Because estrogen can maintain bone content, the decrease of estrogen level will lead to the decrease of bone density, and sometimes lead to osteoporosis. With the decrease of bone density, bones become more fragile and prone to fracture.
Within 2 years after menopause, the bone loss is about 3-5% every year, and then 1-2% every year.
The problem of postmenopausal osteoporosis deserves every postmenopausal woman's attention. First, strengthen exercise, but moderately, to avoid osteoporosis leading to fractures; Second, pay close attention to safety in daily life to prevent fractures; The third is to strengthen nutrition. Calcium can be supplemented appropriately, such as eating more milk and using more seafood and other foods.
What about postmenopausal osteoporosis? We say that with the change of the present environment, the menopausal age of women is a little younger. Some people may be menopausal before the age of 40, and some people may be menopausal in their fifties, but one of the problems brought to women after menopause is osteoporosis!
The so-called postmenopausal osteoporosis in women is largely due to the decrease of estrogen in the body, and the activity of osteoblasts in our body also decreases, and the most important thing is that the activity of osteoclasts increases. In other words: less long bones, more destroyed bones! This is also the main reason for postmenopausal osteoporosis in women!
However, clinically, I found that most osteoporosis women who come to see a doctor know that calcium should be supplemented in time, and some even know that vitamin D should be supplemented. However, for postmenopausal women who have really suffered from osteoporosis, calcium and vitamin D are only supplemented to meet the calcium demand in their bodies, and anti-osteoporosis drugs must be used to treat osteoporosis. There are two main types of drugs: one is to inhibit the activity of osteoclasts and make them stop destroying our bones; The other is to promote the activity of osteoblasts and make them active!
Therefore, women with real postmenopausal osteoporosis can't stop the development of osteoporosis by eating some calcium and supplementing some vitamins. They must use anti-osteoporosis drugs! At the same time, it is suggested that women should consciously supplement some calcium and vitamins after the age of 35 to prevent osteoporosis in advance!
What is osteoporosis? According to the definition of the World Health Organization, osteoporosis is a systemic bone disease characterized by decreased bone mass and degradation of bone microstructure, which leads to increased bone fragility and prone to fractures.
What is postmenopausal osteoporosis? Postmenopausal osteoporosis is a common disease related to aging. Due to estrogen deficiency, bone mass decreases and bone structure changes, which makes bones brittle and prone to fracture, as well as pain, bone deformation and complications caused by fracture. This is a common systemic skeletal metabolic disease in postmenopausal women.
What are the hazards of osteoporosis? Osteoporosis is a common and frequently-occurring disease, which seriously threatens middle-aged and elderly people. Pain and lack of activity are common clinical manifestations, and the most serious consequence is fracture. Common parts are hips, spine, wrists and ribs. With the acceleration of population aging, osteoporotic fractures are becoming more and more common. Spinal fracture will cause short stature, hunchback and thoracic deformity, which will affect respiratory function. The fracture caused by osteoporosis in the elderly is not easy to heal, which leads to long-term bed rest, inability to take care of themselves and depression, which seriously affects the physical and mental health and quality of life of the elderly. Complex respiratory and circulatory diseases will endanger life and increase the mortality of patients.
Why do postmenopausal women get osteoporosis easily? For women, the effect of estrogen on bone metabolism is mainly to inhibit bone resorption. After menopause, especially menopause, the secretion of estrogen is obviously reduced, and the metabolic function of the whole body is reduced, which causes the imbalance of bone calcium metabolism, thus reducing bone mass, bone microstructure, bone brittleness and bone density, making patients prone to osteoporosis. Because the bones of osteoporosis patients are brittle, easy to fracture and difficult to heal, which increases the bed rest time of patients and the probability of fracture again is relatively high.
How to treat postmenopausal osteoporosis? Drugs for treating postmenopausal osteoporosis can be divided into three categories according to their mechanism of action:
1. Bone resorption inhibitor 1, bisphosphonate.
Representative drugs: alendronate sodium, etidronate disodium, risedronate sodium, zoledronic acid;
Pharmacist's suggestion: oral bisphosphonate has more gastrointestinal adverse reactions. Therefore, you should swallow directly when taking the medicine, avoid chewing or sucking, and keep your upper body upright for half an hour after taking the medicine. And avoid taking it with other foods and drinks, so as not to affect the efficacy.
2. calcitonin
Representative drug: salmon calcitonin;
Pharmacist's suggestion: this medicine will cause bone pain, and it is not recommended to use it for a long time (no more than three months).
3, estrogen and progesterone
Representative drugs: estradiol and estriol;
Pharmacists suggest that long-term use of estrogen alone will increase the incidence of endometrial cancer, while combined use with progesterone can prevent endometrial cancer, so it is necessary to monitor the thickness of endometrium when using it.
4. Estrogen receptor modulators
Representative drug: raloxifene;
Pharmacists suggested that the drug can increase venous thromboembolism, and liver function should be monitored when using it. Women who are likely to get pregnant are prohibited.
Two. Drugs for promoting bone formation 1, fluorine preparation
Representative drug: sodium fluoride;
Pharmacists suggest that excessive use can cause calcium deficiency and osteomalacia.
2. Parathyroid hormone
Representative drug: teriparatide;
Pharmacists suggest that the longest treatment time should not exceed two years, and patients can only receive one two-year treatment for life.
3. Strontium salt
Representative drug: strontium ranelate;
Pharmacists suggest that this drug will increase heart problems, so cardiovascular tests must be carried out before and during taking it.
Third, other drugs 1, calcium preparations
Representative drug: calcium glucosamine;
Pharmacists suggest that the recommended daily intake of calcium for postmenopausal women is 1000- 1500mg of elemental calcium, which is often used in combination with vitamin D.
2, vitamin D agent
Representative drugs: vitamins D2 and D3, calcitriol and alfacalcidol;
Pharmacist's suggestion: In addition to oral medicine, vitamin D can be well supplemented by increasing outdoor activities and getting more sunshine.
Reviewers: Wei Li, First Affiliated Hospital of Guangzhou Medical University, Guangdong Pharmaceutical Association; Huang Biyu, Guangdong Provincial Pharmaceutical Association, Guangdong Provincial People's Hospital.
The above answers are provided by Huang Ailin, the First Affiliated Hospital of Guangzhou Medical University, Guangdong Pharmaceutical Society!
Osteoporosis is a decrease in bone cell content per unit volume caused by endocrine abnormalities in the elderly, which is easy to occur in women after menopause. The pathogenesis of primary osteoporosis is still unclear, and women are more likely to occur than men. For postmenopausal osteoporosis, besides strengthening exercise and taking calcium-rich nutrients such as milk and tofu, we should also bask in the sun regularly, exercise and improve our mood.
Osteoporosis is an increasingly serious social health problem all over the world. With the development of the disease, osteoporosis will greatly increase the probability of fracture. According to the research of International Osteoporosis Association (IOF), the prevalence of osteoporosis in women over 50 years old is 30%, and that in women over 80 years old is as high as 95%, which has developed into one of the top ten common diseases in the world.
It was once thought that with the aging of the population, by 2050, the incidence of global fractures will increase by more than three times, and the number of patients with hip fractures will increase significantly, nearly half of which will occur in Asia, especially in China. The risk of hip fracture in women is greater than that of breast cancer and ovarian cancer.
However, the awareness rate of osteoporosis in China is very low at present. More than 70% of postmenopausal women with osteoporosis have not been treated, and more than half of them only choose calcium supplementation.
Let's talk about why women are prone to osteoporosis after menopause.
This is related to the decline of ovarian hormone synthesis function, which is characterized by systemic bone loss and changes in bone microstructure, resulting in increased bone brittleness and easy fracture. Different from senile osteoporosis, cancellous bone changes obviously. There are many reasons for postmenopausal osteoporosis, which are related to heredity, diet, lifestyle, exercise and psychology, but the decrease of estrogen after menopause is the main reason.
In fact, when estrogen is deficient, calcitonin synthesis decreases, and the influence of adrenocortical hormone is relatively enhanced, which will lead to decreased bone absorption, bone destruction or increased calcium excretion, thus leading to decreased bone mass and osteoporosis.
How to treat postmenopausal osteoporosis?
Estrogen receptor modulators are usually selected for the treatment of osteoporosis in postmenopausal women. Features: It has estrogen-like effect on bone tissue and cardiovascular system, but has no effect on breast and uterus.
Function: increase bone mass, reduce the risk of fracture, improve lipid metabolism, provide cardiovascular protection benefits while protecting bones, and reduce the risk of breast cancer, endometrial hyperplasia and ovarian cancer without stimulating breast tissue and endometrium.
Raloxifene is the first drug approved by FDA to prevent and treat osteoporosis in postmenopausal women.
Raloxifene, as a selective estrogen receptor modulator, has selective excitatory or antagonistic activity on estrogen-acting tissues.
Effect of (1) on bones
In the treatment of postmenopausal osteoporosis, raloxifene can reduce the incidence of vertebral fracture, maintain bone mass and increase bone density.
① Fracture incidence: In a study of 7705 postmenopausal women with osteoporosis or osteoporosis with fracture with an average age of 66 years, the incidence of vertebral fracture decreased by 47% and 365438 0% respectively after 3 years of raloxifene treatment.
② Calcium kinetics: The effects of raloxifene on bone remodeling and calcium metabolism are similar to those of estrogen. Raloxifene (60mg/ day) can reduce bone absorption, at the same time, make calcium balance move forward and reduce urinary calcium loss.
(2) Effects on lipid metabolism and cardiovascular risk factors.
Clinical studies show that raloxifene 60mg daily can significantly reduce total cholesterol (3 ~ 6%) and low density lipoprotein cholesterol (4 ~ 65,438+00%). Women with the highest basal cholesterol level have the largest decline. The levels of high density lipoprotein cholesterol and triglyceride did not change significantly.
(3) Effect on endometrium
After three years of clinical treatment for osteoporosis patients, it was found that the endometrial thickness of raloxifene group did not change compared with the baseline. There was no difference in the incidence of vaginal bleeding and vaginal discharge between raloxifene group and placebo group.
1, raloxifene can increase the risk of venous thromboembolism events, and some patients who need long-term immobilization due to illness or other circumstances should stop taking drugs.
2. Any uterine bleeding during taking raloxifene is an accident, and experts should be asked to do a comprehensive examination in time. The most common causes of uterine bleeding during medication are endometrial atrophy and bisexual polyps.
3. Raloxifene is mainly metabolized in the liver, so women with liver dysfunction should not use such drugs. If serum bilirubin, alanine aminotransferase and aspartate aminotransferase are found to increase during medication, the drug should be stopped immediately.
4. No matter the patient takes the medicine, it will cause hyperlipidemia, and raloxifene will further increase the serum glycerol level, so such patients need to test the serum glycerol level and increase or decrease the dose according to the doctor's advice.
5. Raloxifene is not suitable for male patients.
In addition, head nurse Yang reminded postmenopausal women with osteoporosis that walking and sun exposure should be moderately increased in their daily lives, which can have a good therapeutic effect.
After menstruation stops, women lack a detoxification channel. In addition to exercising more, they should also supplement the mold needed by the body.
Due to the decline of ovarian function after menopause,
Leading to a significant decrease in female estrogen levels,
Estrogen deficiency leads to increased bone resorption,
Rapid bone loss leads to osteoporosis.
It is suggested to establish a healthy lifestyle and insist on exercise.
Eat a healthy diet, supplement enough protein and high-calcium food,
Increase the time spent in the sun. Estrogen can be supplemented if necessary.