When women reach the stage of menopause the decline in ovarian estrogen is associated with several changes in the body including health and growth of bones. Loss of bone quality and strength is one of the biggest changes women experience during midlife which can often lead to osteoporosis where bone becomes porous, spongy, weak, and brittle. The bone mass and density were built in the mid-twenties and thirties. Once menopause begins the estrogen secretion level declines which leads to increased osteoclast formation and enhanced bone resorption for about five to eight years, which then slows down later. Without the normal secretion of estrogen, the body is unable to produce bone at the same rate that keeps up with bone loss. This results in weaker and more fragile bones which can increase the risk of bone fractures. Until fracture, osteoporosis silently devours bone tissues without any noticeable symptoms. 

The amount of bone loss during aging is calculated by the net amount of bone removed and formed in the body. After menopause, the increase in bone fragility results in reduced periosteal bone formation and increased endocrinal resorption. Women with high remodeling have a great loss of bone mass and strength, whereas those with low remodeling lose less bone and strength. Another reason menopausal women are at higher risk of osteoporosis is not getting enough minerals to boost their bone density. By the time women reach age 40 they slowly begin to lose calcium which contributes to the bone mass. During the menopausal transition, the average reduction in bone mass density is about 10% which increases to 20% after 4-5 years of menopause.

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