Delay in Diagnosis of Menopause-like Condition in Young Women Linked to Low Bone Density
A recent study has found that a delay in diagnosing a menopause-like condition in women and young girls is linked to low bone density which may increase risk for osteoporosis and fractures later in life. The African-American and Asian patients in the study were more likely to have low bone density than were their white counterparts.
Waring: According to researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, women and young girls with a menopause-like condition face an increased risk of low bone density. This may lead to osteoporosis, which makes bones weak and more likely to break.
Dr. Nelson: Bone health is like our bank account.
Waring: Dr. Lawrence M. Nelson is head of the Integrative Reproductive Medicine Unit at NICHD:
Dr. Nelson: We need to build strong bones when we're young to help us avoid osteoporosis when we're older. And it turns out that the hormones that come from the ovary that cause women to have regular cycles actually help them build strong bones.
Waring: Estrogen is the hormone produced in the ovaries; and it helps bones absorb calcium. Dr. Nelson says that the menstrual cycle is linked to the function of the ovary and when women and teens are having regular menstrual cycles, it's a sign that their ovary is making the hormones they need.
Dr. Nelson: This is something positive about the menstrual cycle.
Waring: Yet in one out of 100 women under the age of 40, the ovaries prematurely stop making estrogen. Dr. Nelson studied this.
Dr. Nelson: We worked with women that have a problem called primary ovarian insufficiency. It used to be called premature menopause, meaning that young women stopped having menstrual periods; and they may also get the symptoms of hot flashes and vaginal dryness that comes along with estrogen deficiency.
Waring: Dr. Nelson explains that one finding of a recent study, published in the Journal of Clinical Endocrinology & Metabolism, is that the menstrual cycle helps build strong bones.
Dr. Nelson: Another major finding is, if the menstrual cycles become irregular before age 20, this puts those women at greater risk of having a bone density below normal.
Waring: Because the main symptom of primary ovarian insufficiency—irregular or stopped menstrual periods—may be overlooked, delays in diagnosis are common.
Dr. Nelson: The longer women had to wait before the doctors find out that their ovaries weren't working right because they weren't having periods regularly, the more at risk they were for having an abnormally low bone density.
Waring: Dr. Nelson adds that by diagnosing the condition early, and replacing needed hormones, these women can protect their bones from weakness and fractures. He also stresses the importance of nutrition:
Dr. Nelson: Vitamin D is very important in helping build strong bones. And calcium in your diet is very important in helping build strong bones.
Waring: African-American women generally have less risk for low bone density than white women have. Yet Dr. Nelson says this study had some surprising results.
Dr. Nelson: So we found that black women and Asian women were at more risk because they were having more problems making sure they have enough calcium and vitamin D.
Waring: Dr. Nelson urges women to see their doctors:
Dr. Nelson: Women of color who are having irregular menstrual cycles should get in and get evaluated especially because they're at increased risk of abnormally low bone density, compared with white women. The data suggest that if they correct their vitamin D and their calcium levels and intake, then they'll be at less risk of developing osteoporosis.
Waring: Dr. Nelson also stresses that adolescent women should not delay seeking treatment:
Dr. Nelson: The teen years are a critical time for building bone for young women. And if young teenagers are not having the hormones from their ovary and they're missing vitamin D and they're having inadequate calcium intake, and if they're not taking their hormone replacement in this condition of primary ovarian insufficiency, they're at increased risk too. So mothers and daughters need to be paying attention to the menstrual cycle as a vital sign and as a sign that their hormones are there to help them build strong bones.
Waring: For more information on primary ovarian insufficiency, visit www.nichd.nih.gov. This is Belle Waring, National Institutes of Health, Bethesda, Maryland.
About This Audio Report
Reporter: Belle Waring
Sound Bite: Dr. Lawrence M. Nelson
Topic: primary ovarian insufficiency, menstrual cycle, bone density, osteoporosis, young women, adolescent women, African-American women, Asian women, health disparity, vitamin D, calcium