Jean Hailes research update

Reducing the risk of fractures for women at menopause and beyond

In the first three years after menopause, women experience rapid bone loss that then continues at a rate of about 1% each year.

Bones become weaker because of a loss of oestrogen during menopause, and because the body is less able to absorb and conserve calcium to maintain bone strength.

One in three women over 50 will experience an osteoporosis-related fracture – most often a vertebral or spinal fracture that goes unrecognised and untreated.

But even minor fractures increase the risk of death two-fold in women. A Jean Hailes study – the STOP Fracture Study – investigated the rate of osteoporosis-related fractures in postmenopausal women who were attending hospitals for treatment for an unrelated condition. Once fractures were identified, the study also looked at how often these women were prescribed preventive treatment for fractures, and how likely they were to follow that treatment.

Results found just over half of women over the age of 65 who went to hospital for an unrelated condition had one or more undiagnosed minor vertebral fractures.

About half of women were on some form of osteoporosis preventive agents, including calcium or vitamin D supplementation. But the research found that only a fraction of women continued to take the recommended medication or supplements 12 months after their initial hospital visit and few were started or sustained on the more effective medical preventive agents.

The Jean Hailes Research Team believes only about one-third of vertebral fractures are diagnosed – which means many women miss opportunities to prevent future fractures. Yet a simple lateral chest X-ray is an effective screening tool to identify fractures in high-risk patients including women over 65 years of age. Most importantly, any woman:

• with a high risk of osteoporosis, family history of fracture, smoker, on steroid (prednisolone) tablets, increasing age or prior fracture should see their doctor to assess future fracture risk
• over 65 years of age with a fracture due to a fall or minor trauma needs to be evaluated for fracture risk and treated to prevent future fractures

Given the high incidence of fractures in women after menopause, and the approximate $1.9 billion dollars annual cost of osteoporosis-related fractures in Australia, health professionals need to be aware of the fracture risk for women after menopause.

Women at this life stage also need to know their fracture risk and how they can work with their GP to prevent fractures occurring in the future.

Content Updated November 23, 2009