For years osteoporosis was called a condition of low bone mineral density caused by hormone loss during menopause, and with some exceptions physicians checked up on the supposed damage to bones afterwards.  Science has progressed from there, recognizing that 1) osteoporosis does not follow de facto from menopause, and that 2) lifestyle factors, gut health and western pharmaceuticals have a more potent effect on bone health – outer bone and inner bone mineral – among women and men.

Now scientists at the University of Michigan have turned to personalized medicine and diagnostic protocols to confirm an hypothesis that monitoring women through menopause would turn up subtle and larger differences in response of bone to hormone decline, and that the differences show in outer bone fragility, inner bone mineral density and how both may or may not put a woman at risk of fracture. 

The lead investigator, Karl Jepsen, Ph.D. associate chair of research and professor of orthopaedic surgery at Michigan Medicine, says that changes in bone structure and bone mass during aging are not well understood. 

“We hypothesized that age-related changes in bone traits also depend on external bone size, which is easily measured.” So the scientists measured bone mineral density and bone area.  The women cohorts, who were aged between 42 and 52 years old, had a uterus intact and were still menstruating, were followed from 1996 to 2017. The results surprised researchers:  some women lost bone strength; some women did not.  Some showed greater areal density; some showed greater mineral density loss. 

Dr. Jepson and his colleagues concluded that monitoring a woman’s bone health through menopause would allow physicians to intervene where necessary and with the appropriate intervention. 

We anticipate, and hope, that research scientists concerned with bone health will turn their attention similarly to men at risk of fragile bones.

Karl J. Jepsen, Andrew Kozminski, Erin M.R. Bigelow, Stephen H. Schlecht, Robert W. Goulet, Sioban D. Harlow, Jane A. Cauley, Carrie Karvonen-Gutierrez. Femoral Neck External Size but not aBMD Predicts Structural and Mass Changes for Women Transitioning through Menopause. Journal of Bone and Mineral Research, 2017; DOI: 10.1002/jbmr.3082