Page 64 - GALENIKA MEDICAL JOURNAL

THE RELATIONSHIP BETWEEN

MENOPAUSE AND BONE HEALTH

Artur Bjelica 1, 2 lack of exercise, smoking, alcohol consumption, metabo-
1 Faculty of Medicine, University of Belgrade, Belgrade, Serbia lic disorders, hematologic abnormalities, kidney diseases,
2 Clinic for Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi malignant diseases, and infections. Postmenopausal oste-
Sad, Serbia oporosis is associated with a lack of estrogen that occurs
following the cessation of ovarian function in the years
Corresponding author: following a woman's active reproductive period. Scientific
evidence indicates that the function of estrogen in the bone
Prof. dr Artur Bjelica
remodeling process is very significant, as estrogen plays a
Medicinski fakultet Univerziteta u Novom Sadu, role both in bone formation and in the prevention of bone
Hajduk Veljkova 3, Novi Sad, Srbija resorption.
artur.bjelica@mf.uns.ac.rs

Physiological changes during
the menopausal period
Abstract
Menopause is part of the general aging process that
The paper describes menopausal events and their affects the female reproductive tract, after which women
1
impact on bone health. Physiological events in the cease menstruation . The term menopause signifies a wo-
menopausal period as well as the pathophysiological man's final menstrual period. According to the definition,
basis for the occurrence of osteoporosis were considered. we speak of menopause if more than 12 months have pa-
ssed since the last menstrual period, and signs such as
Postmenopausal women are at high risk for osteoporosis vasomotor and urogenital symptoms are present. Perime-
and bone fractures. The genesis of this problem lies in nopause represents the period during which issues such
two factors - aging and loss of gonadal function, or their as vasomotor symptoms and irregular menstrual bleeding
combination. Senile osteoporosis is associated with the begin, heralding the end of a woman's reproductive period .
2
aging process of the organism, and postmenopausal This period can begin 5 to 10 years before menopause and
osteoporosis is primarily a consequence of estrogen by definition includes the first year after menopause. Me-
deficiency. Osteoporosis is the main cause of bone nopause typically occurs around the age of 50-51 for most
fractures in the elderly population. Numerous markers women. Symptoms of the transitional period usually begin
around 45.5-47.5 years of age. If menopause occurs before
of bone formation and breakdown have been described the age of 45, it's termed early menopause, and if it occurs
as biochemical markers of osteoporosis. For diagnostic before the age of 40, it's referred to as premature menopau-
purposes, double X-ray absorptiometry of the hip se (premature ovarian insufficiency) . Factors that contri-
2-4
and spine is used, which is the gold standard in the bute to early onset menopause include smoking, autoim-
diagnosis of osteoporosis. Alternatively, quantitative mune diseases, and genetic predisposition associated with
5
ultrasonography can be performed, which is a good the fragile X chromosome .
method, but the measurements are not sufficiently Menopause occurs as a result of the decreased sensiti-
precise as in other imaging techniques. An overview vity of the ovaries to gonadotropin stimulation, leading to
of the therapeutic possibilities of measures to prevent disruptions in folliculogenesis and steroidogenesis. During
osteoporosis in the postmenopausal period is presented. the perimenopausal period, menstruation becomes irregu-
lar due to anovulation or failure of follicle maturation. Clini-
Keywords: menopause, bone health, osteoporosis, cal studies have indicated that the incidence of anovulatory
prevention cycles increases rapidly after the age of 40 .
2-6
The first sign of perimenopause in women who still have
completely regular menstruation and ovulation is a shorter
Introduction menstrual cycle. A shorter duration of the menstrual cycle
occurs due to the shortening of the follicular phase of the
Bones represent living tissue that plays an essential role cycle, due to the decrease in the number of functional follic-
in maintaining the structural integrity of the human body. les. After the age of 40, the granulosa cells produce less and
Various factors can affect bone health: hormonal imba- less amounts of inhibin A and B, so their level at the age of
lance, certain hereditary conditions, inadequate nutrition,

62 DOI: 10.5937/Galmed2409072B