Severity of hot flashes may predict hip fracture risk

When it comes to addressing the risk of hip fracture among women, it is important for doctors to note in orthopedic EMR patient files if and when menopause has occurred. This phase in a woman's life leads to significant hormonal shifts that can negatively impact bone health and lead to other symptoms, such as hot flashes.

Recently, a team of scientists from the University of California, Los Angeles, suggested that the severity of hot flashes may help predict the risk of hip fractures among menopausal and postmenopausal women, as published in the Journal of Clinical Endocrinology & Metabolism.

'Improved understanding would help clinicians'
Menopause causes a series of changes in the bodies of women. Among the most significant changes is a faster rate of bone loss, which begins to exceed the rate of bone growth. Ultimately, the risk of osteoporosis increases, making women more prone to broken bones. According to the American College of Obstetricians and Gynecologists, the most rapid bone loss occurs over the course of three years, starting from one year before the final menstrual period. The most impactful and detrimental fractures occur at the hips and vertebrae, and can lead to disability and high medical costs.

Additionally, about 60 percent of menopausal women experience hot flashes. These sudden and sweeping increases in body temperature, which can be disruptive to sleep, may recur over the course of several years.

To better understand the link between menopause and hip fractures, the authors of the new study examined data from more than 23,000 women, all of whom participated in the Women's Health Initiative Clinical Trial. All subjects, who were between the ages of 50 and 79 years, described their menopause symptoms and had all possible bone fractures noted for an average of eight years. Additionally, a subset of more than 4,900 women underwent bone mineral density tests.

Results showed that subjects who reported moderate to severe hot flashes were more likely to have hip fractures compared to women who did not report any menopause symptoms. The bone mineral density tests also revealed that those who experienced the signs of menopause tended to have weaker bones in their neck and spine, unlike women who were not experiencing the tell-tale signs of menopause.

"More research is needed to illuminate the connection between bone health and menopausal symptoms such as hot flashes," study co-author Carolyn Crandall, M.D., MS, of the David Geffen School of Medicine at UCLA, said in a statement. "Improved understanding would help clinicians advise women on how to better prevent osteoporosis and other bone conditions. Women who have hot flashes and want to protect their bones may benefit from healthy lifestyle habits such as avoiding smoking and excessive alcohol consumption, exercising and getting sufficient calcium and vitamin D."

Different strategies will keep bones strong
According to the National Institute on Aging, women ages 50 years and older need at least 1,200 milligrams of calcium every day. Additionally, everyone between the ages of 51 and 70 needs at least 600 international units of vitamin D. After 70, that figure increases to 800 IUs. When it comes to physical activity, the best exercises are the ones that put weight and pressure on the bones. These include walking, jogging, dancing and tennis. Additionally, exercises to maintain balance and strength will help prevent accidental falls.

There are also several medications that may help with bone loss, including bisphosphonates. Additionally, doctors may prescribe hormone replacement therapy to replace what the body does not produce during menopause, according to ACOG. These hormones may help prevent fractures, but different combinations of hormones may increase the risk for other health problems, including various types of cancer. A comprehensive medical evaluation and discussion with the patient will help determine the best course of action.