The link between menopause and osteoporosis, approved as a new drug

A woman's body goes through many changes throughout her life. Menopause brings some of the most significant changes after puberty.

Awareness of how much menopause can affect women's physical and mental health has increased in recent years. This stage of life not only marks the end of menstruation, but can also have lasting effects on a woman's bones, muscles and general well-being.

During perimenopause (the period before the onset of menopause) and menopause, the female sex hormone estrogen decreases. This hormone is crucial for maintaining bone density and strength, and the decline in estrogen levels also leads to a decrease in bone density.

This means that women who are in or after menopause are at much higher risk of osteoporosis. Osteoporosis is a condition that weakens bones and makes them prone to breaks and fractures.

According to the Endocrine Society, one in two postmenopausal women suffers from osteoporosis. The society cites research showing that up to 20% of bone loss can occur during menopause and postmenopause. Globally, osteoporosis affects about one in ten women over 60.

The impact of osteoporosis on quality of life

The most common injuries in osteoporosis include wrist fractures, hip fractures and vertebral fractures.

However, fractures can occur in other places, says the NHS, such as in the arm or pelvis. Sometimes a cough or sneeze can be so violent that it causes a rib fracture or a partial collapse of a spinal bone.

Bone fractures can significantly impact daily life and affect a person's independence. They are also associated with increased mortality, says the National Institute for Health and Care Excellence (NICE).

It went on to say that “people with osteoporosis live in fear of breaking another bone,” which causes them to become “anxious and withdrawn.”

“They reported having difficulty completing everyday tasks and being unable to do some of the things they once enjoyed, such as going for walks. It can also affect their ability to care for others, such as their partners.”

Because women are far more likely to provide care than men (Office for National Statistics figures show that in England and Wales, the proportion of women providing unpaid care is higher than that of men), osteoporosis in postmenopausal women can have a significant negative impact on their quality of life.

New bone-strengthening drug aims to help women after menopause

According to the Royal Osteoporosis Society, hormone replacement therapy (HRT) is generally considered the most appropriate treatment for osteoporosis. HRT helps relieve the symptoms of menopause by replacing the female hormones that have decreased during this phase.

However, on Wednesday 7 August, NICE announced that a new bone-strengthening drug for postmenopausal women would be available on the NHS in England within the next three months.

The drug abaloparatide can protect women from osteoporosis, the drug regulator explained. It is supplied in the form of an injection in a pre-filled pen, which those affected can administer themselves once a day at home.

Dr Nicky Peel, clinical trustee of the Royal Osteoporosis Society, told BBC Radio 4's Today programme that the new drug is “very well tolerated” by most people – but some patients may experience side effects such as nausea, headaches and heart palpitations in the early stages of treatment.

However, abaloparatide is suitable for most people who are at very high risk of bone fractures. The approval of the drug, manufactured by Theramex, is expected to benefit over 14,000 women.

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