Health
PT Health Watch: Menopause increases risk of bone loss, fractures, says expert
Menopause, the natural stage marking the end of a woman’s reproductive years, can significantly affect bone health and increase the risk of osteoporosis and fractures due to declining oestrogen levels, a medical expert has said.
Although menopause has important health implications, it remains a frequently overlooked issue within Nigeria’s sexual and reproductive health and rights framework.
According to the World Health Organisation (WHO), menopause occurs when a woman’s menstrual periods stop permanently because of declining levels of oestrogen and the loss of ovarian follicular function. As a result, the ovaries stop releasing eggs for fertilisation, making natural conception no longer possible.
Common symptoms associated with menopause include hot flushes, night sweats, irregular menstrual flow, vaginal dryness, pain during sexual intercourse, urinary incontinence, sleep disturbances, mood changes, anxiety and depression.
Perimenopause refers to the transition period leading to menopause and extends until one year after the final menstrual period, while postmenopause begins after a woman has gone 12 consecutive months without menstruation.
In Nigeria, women generally attain menopause around the age of 48 and above as part of the natural ageing process.
Menopause and bone health
Speaking with PT Health Watch, Qudus Lawal, an obstetrician and gynaecologist, said menopause disrupts hormonal balance, leading to increased bone breakdown and reduced bone formation.
According to him, while nearly all women experience some degree of bone loss after menopause because of declining oestrogen levels, not all will develop osteoporosis or sustain fractures.
He explained that bone density before menopause plays a major role in determining a woman’s risk of osteoporosis later in life.
Using a financial analogy, Mr Lawal described bone health as a balance between deposits and withdrawals.
“The stronger the bone density a woman builds before menopause, the better protected she is against the accelerated loss that occurs afterwards,” he said.
Why bone loss increases after menopause
Mr Lawal explained that oestrogen normally suppresses osteoclasts, the cells responsible for breaking down bone tissue.
However, when oestrogen levels fall after menopause, these cells become more active, while osteoblasts, the cells responsible for building new bone, are unable to replace bone at the same rate.
This imbalance gradually weakens bones and increases the risk of osteoporosis and fractures.
Maintaining healthy bones after menopause
Mr Lawal recommended a combination of proper nutrition, regular exercise and preventive healthcare measures to maintain bone health after menopause.
He advised women to consume balanced diets rich in calcium and vitamin D, engage in weight-bearing and muscle-strengthening exercises, and take steps to prevent falls.
“When you take foods and supplements that are rich in those essential nutrients, it helps build the bone,” he said.
He stressed the importance of early intervention, noting that bone density loss is often silent and may not produce symptoms until complications occur.
“One of the ways people present is that they grow shorter. Normally, once you get to a certain age after puberty, you are not supposed to grow shorter.
“But many of our mothers begin to lose height over time, which may result from age-related spinal degeneration and bone loss,” he said.
According to him, many women only become aware of significant bone loss after suffering fractures.
“The fracture can be due to a fall, sometimes a little push that you normally have without having symptoms. Just a little trip in the bathroom could lead to a major fracture,” he added.
READ ALSO: Women demand fertility, menopause coverage in workplace health insurance – Report
Mr Lawal noted that in some countries, bone density screening forms part of routine wellness checks for postmenopausal women, helping identify individuals at high risk and allowing for early intervention.
He urged women to adopt healthy lifestyles and prioritise bone health long before menopause.
According to him, the goal is to ensure women build and maintain strong bone density before menopause to minimise the impact of hormonal changes later in life.
The World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) have warned that funding shortfalls could reverse recent gains in routine immunisation across lower-income countries despite record vaccination coverage achieved in 2025.
The warning is contained in the latest WHO and UNICEF Estimates of National Immunisation Coverage (WUENIC), analysed by Gavi, the Vaccine Alliance.
According to the report, lower-income countries immunised a record 73 million children with Gavi-supported vaccines in 2025, the highest number ever recorded.
It said three-fourths of all countries maintained or improved coverage with the third dose of the diphtheria, tetanus and pertussis (DTP3) vaccine in 2025, the highest proportion in more than two decades.
It added that two-thirds of countries have a DTP3 coverage rate of 80 per cent or higher.
Average coverage across Gavi-supported vaccines, referred to as the “breadth of protection”, reached 65 per cent in 2025, matching the global average for the first time.
According to the report, this represents a 16-percentage-point increase since 2019, driven largely by the introduction and expansion of new vaccines.
Progress in fragile settings
The report also highlighted improvements in countries affected by fragility and conflict.
Average DTP3 coverage across the 12 countries classified as fragile or conflict-affected increased by five percentage points to 66 per cent in 2025.
Sudan recorded the world’s largest improvement, with DTP3 coverage rising by 32 percentage points.
Despite the progress, the report noted that these countries have yet to recover to pre-pandemic immunisation levels.
It added that one-quarter of all zero-dose children in lower-income countries live in fragile and conflict-affected settings.
HPV and malaria vaccines
The report highlighted progress in efforts to prevent cervical cancer and malaria through vaccination.
According to the findings, lower income countries have now protected 95 million girls with the human papillomavirus (HPV) vaccine, including 79 million in the past three years alone. This exceeded Gavi’s target of protecting 86 million girls by the end of 2025.
The report said HPV vaccine coverage now stands at 29 per cent, close to the global average of 31 per cent.
It also noted that malaria vaccines are now being delivered through routine immunisation programmes in 25 African countries, representing more than 70 per cent of the world’s malaria burden.
Although WUENIC does not yet include malaria vaccine data, the report said countries are already reporting reductions in severe malaria cases, deaths and hospitalisations.
It cited Ghana, where under-five malaria deaths fell by 86 per cent between 2019 and 2024, and Burkina Faso, which reported a 32 per cent decline in malaria cases between 2024 and 2025 following nationwide expansion of the malaria vaccine programme.
Measles immunity gaps
Despite the gains, the report warned that immunity gaps for measles remain a significant concern.
Coverage with the first dose of the measles-containing vaccine remained at 80 per cent in lower income countries, while coverage with the second dose increased to 72 per cent in 2025.
However, about 15.6 million children in Gavi-supported countries still missed their first dose of the measles vaccine.
The report warned that the immunity gaps remain a significant concern because of the high transmissibility of the virus and the risk of serious outbreaks.
Funding concerns
Despite the progress recorded in 2025, Gavi warned that sustaining the gains will require continued investment.
The report noted that 2025 was the last fully funded year of Gavi’s current strategic period.
However, it stated that Gavi’s next strategic period, covering 2026 to 2030, is not yet fully funded, putting progress at risk.
According to the report, reduced financing could affect investments in key areas, including malaria vaccine programmes, the introduction of hexavalent and multivalent meningitis vaccines, preventive vaccination campaigns and global vaccine stockpiles.
The report also identified fiscal pressures, geopolitical instability, disease outbreaks, rising birth cohorts and vaccine hesitancy as challenges that are making progress more difficult.
Although the number of zero-dose children declined in 2025, about 9.5 million children in lower income countries still had not received a single vaccine dose.
The report stressed that reaching these children, many of whom live in underserved communities, remains critical to saving lives, promoting equity and strengthening global health security.
READ ALSO: WHO warns as largest-ever Bundibugyo Ebola outbreak surpasses 1,400 cases
Sustained investment
The Chief Executive Officer of Gavi, Sania Nishtar, said the record level of immunisation demonstrates what can be achieved when governments and partners work towards a common goal.
Ms Nishtar said sustaining the progress would require continued commitment as countries face funding constraints, geopolitical uncertainty and increasing disease outbreaks. She added that greater efforts would also be needed to reach children who still do not have access to immunisation.
“The historic levels of immunisation that we are seeing across lower income countries shows what can be achieved when all stakeholders work together towards a shared objective”, she said.
Ms Nishtar noted that as Gavi heads into a new five-year period, its greatest challenge will be maintaining the momentum in the face of funding constraints, geopolitical uncertainty and increasing outbreaks, while working harder to reach children who still do not have access to immunisation.
She called on countries to increase domestic financing for immunisation and urged donors to support Gavi’s 2026–2030 strategic period.
The Yobe State Government has approved the enrolment of state and local government retirees into the Social Equity Programme of its health insurance scheme.
The Executive Secretary of the Yobe State Contributory Healthcare Management Agency (YSCHMA), Babagana Tijjani, disclosed this in a statement on Tuesday in Damaturu.
Mr Tijjani said the approval was granted by Governor Mai Mala Buni following a recommendation from the agency.
He said the initiative aims to reduce out-of-pocket healthcare spending among pensioners and improve access to comprehensive, quality healthcare services at YSCHMA-accredited health facilities.
According to him, the approval underscores the state government’s commitment to improving the welfare of retirees by ensuring they continue to access quality healthcare after retirement.
“This approval is another demonstration of the governor’s commitment to protecting the health and well-being of residents of the state,” he said.
“By bringing retirees under the social equity programme, the government is ensuring that senior citizens can access quality healthcare without suffering financial hardship.”
The executive secretary further said that the inclusion of retirees in the scheme aligned with the administration’s healthcare reform agenda and the state’s drive towards achieving Universal Health Coverage (UHC) by 2030.
He also described the development as a significant step in expanding access to healthcare and strengthening social protection.
READ ALSO: Yobe, Adamawa tighten security to curb illegal mining
Mr Tijjani commended the governor for approving the initiative and reaffirmed the agency’s commitment to its effective implementation.
He said the YSCHMA would work closely with pension unions, relevant government institutions and healthcare providers to ensure a transparent enrolment process and seamless access to healthcare services for eligible beneficiaries.
The News Agency of Nigeria (NAN) reports that the YSCHMA was established under Yobe State Law No. 7 of 2019 to implement the state’s contributory healthcare scheme and promote equitable, affordable and qualitative healthcare services for residents.
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