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Fracture risk with early menopause not minimised by use of calcium, vitamin D

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Women who experience menopause before the age of 40 are known to have a higher fracture risk. But a new study shows that the risk of fracture is still higher even when these women take calcium and vitamin D supplements and/or standard dose hormone therapy.

The findings of the study have been published in Menopause, the journal of the North American Menopause Society (NAMS).

Researchers evaluated data on nearly 22,000 women included in the Women´s Health Initiative (WHI) clinical trials. They found that women with menopause under 40 years had significantly higher risks for fracture than women who experienced menopause between the ages of 40 and 49 or after 50, regardless of treatment intervention.

This suggests that early age of menopause is an independent contributor to postmenopausal fracture risk.

Reporting on the research, NAMS said that although the findings are disappointing for women experiencing an early onset of menopause, the study did open the door to a number of questions and possibilities.

For example, women with early menopause are candidates for hormone therapy until at least the average age of menopause (52 years) to reduce the risks of heart disease, osteoporosis, and cognitive and mood changes.

It is possible that earlier initiation of treatment for those with early menopause with calcium, vitamin D or hormones; more appropriate dosing of young women; longer duration of treatment; or longer duration of follow-up could provide better bone protection and ultimately reduce fracture risk.

“This study highlights the need for healthcare providers to take into consideration a woman´s age at menopause onset when evaluating patients for fracture risk,” commented Dr JoAnn Pinkerton, NAMS executive director. “Women at risk for bone loss need 1,200 mg of calcium per day, with adequate vitamin D, and encouraged to get as much as possible through diet due to concern that too much supplemental calcium may increase atherosclerotic plaque in women. Women with early menopause should discuss whether they are candidates for hormone therapy with their providers, appropriate amount of calcium, vitamin D and hormones.”

http://www.menopause.org/docs/default-source/2016-docs/fracture-risk-and-age-of-menopause.pdf

http://journals.lww.com/menopausejournal/Abstract/publishahead/Age_of_menopause_and_fracture_risk_in.97890.aspx