Osteoporosis is a 'silent' condition that affects more women, than men, all over the world in large numbers leading to weak bones, causing easy fractures. Further, women lose up to 10% bone density during the first 5 years of hitting menopause. Alarmingly, this bone loss occurs with no prior warning signs. Therefore, is there a link between menopause and the onset of osteoporosis in women? Dr. Raju Vaishya, Senior Consultant Orthopedics & Joint Replacement Surgeon at Apollo Hospitals, New Delhi helps us understand how menopause affects osteoporosis and what we can do to prevent it. What is menopause? Menopause is the permanent end of menstruation and fertility, occurring 12 months after the last menstrual period, where there is permanent cessation of the function of ovaries. It usually occurs in women in midlife, during their late 40s or early 50s, and signals the end of the fertile phase of a woman's life. What is osteoporosis? Osteoporosis, literally means 'porous bones' and is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced and the bone micro architecture deteriorates, predisposing the bones to fractures after a trivial trauma. What does depleting bone density due to menopause have to do with osteoporosis? There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. Since the estrogen hormone is bone protective for females. After menopause, bone resorption (osteoclastic) outpaces the building of new bone (osteoblastic). How can one diagnose osteoporosis? The diagnosis of osteoporosis can be made using conventional radiography (X-rays) and by measuring the bone mineral density (BMD). The most popular method of measuring BMD is dual energy x-ray absorptiometry (DXA or DEXA scan). Conventional radiography is useful, both by itself and in conjunction with CT or MRI. However, radiography is relatively insensitive to detection of early disease and requires a substantial amount of bone loss (about 30%) to be apparent on x-ray images. How can one treat osteoporosis in women? There are several medications used to treat osteoporosis, depending on gender. Medications themselves can be classified as A) antiresorptive and B) bone anabolic agents. Antiresorptive agents work primarily by reducing bone resorption, while bone anabolic agents build bone rather than inhibit resorption. Bisphosphonates are the main antiresorptive drugs used for the treatment of Osteoporosis. Exercise regularly: Exercise makes bones and muscles stronger and helps prevent bone loss. Weight-bearing exercises, done at least three to four times a week, are best for preventing osteoporosis when performed right from an early age. It helps women in preserving bone density and avoids osteoporosis when menopause hits. Strength and balance exercises may help you avoid falls, decreasing your chance of breaking a bone. Consult trainers and other health professionals before starting a weight training routine. Calcium supplements: Calcium supplements should be taken on the advice of a doctor. Good forms of calcium supplements are calcium carbonate and calcium citrate. But one should be careful not to get more than 2,000 mg of calcium a day very often. That amount can increase your chance of developing kidney stones. Vitamin D supplementation: Vitamin D helps your body absorb calcium. You can get adequate vitamin D from foods such as eggs, fatty fish like salmon, cereal and milk fortified with vitamin D, as well as supplements. Sunlight is also a good source of vitamin D. People between 51 to 70 ages should have 400-800 IU daily. Diet plays a major role: In order to prevent osteoporosis, right from an early age make sure that all the nutrients are sensibly balanced in your diet such as beans, yogurt, fruits and vegetables. Smaller amounts of lean meat, low-fat milk, oily fish variety such as sardines is recommended too. In order to keep your calcium intake normal, make sure you consume enough milk, yogurt, green leafy vegetables, baked beans, bony fish and dried fruits.