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.
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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 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.
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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.
The federal government has launched the National Guidelines for Public Procurement of Food and Related Services.
The framework introduces nutrition standards for food purchased with public funds as part of efforts to reduce unhealthy diets and curb the growing burden of non-communicable diseases in Nigeria.
The guidelines, unveiled on Monday in Abuja at an event themed “Public Procurement of Food: Promoting a Culture of National Wellness Through the Food Value Chain,” are expected to influence food served in public institutions, including schools, hospitals, correctional centres and military establishments, by setting evidence-based standards on nutrition, food safety and quality.
Delivering his keynote address at the launch, the Minister of State for Health and Social Welfare, Iziaq Salako, said the initiative marks a shift from viewing public procurement as a routine administrative process to using it as a strategic tool to improve public health and national development.
“When the government demands healthier, safer and more nutritious food, it creates incentives for the entire food system to innovate, improve quality and align with higher public health standards,” he said.
Why it matters
Mr Salako said the government remains the country’s largest institutional purchaser of food, meaning procurement decisions have the potential to influence food production, consumer behaviour and nutrition standards across the food value chain.
According to him, the guidelines establish limits on sodium, sugar and unhealthy fats in foods procured by public institutions while encouraging balanced and nutritious diets.
He said the document complements existing national policies, including the National Guideline for Sodium Reduction, the Trans Fat Regulation and the 2023 National Policy on Food Safety and Quality.
Rising burden of unhealthy diets
Mr Salako noted that unhealthy diets contribute to about 7.2 million deaths globally every year, driven largely by excessive consumption of salt, sugar and unhealthy fats as well as inadequate intake of fruits, vegetables and whole grains.
He revealed that the average Nigerian adult consumes between 3.9 grammes and 4.9 grammes of sodium daily, almost double the World Health Organisation’s (WHO) recommended limit of 2 grammes.
Mr Salako added that increasing consumption of sugar-sweetened beverages has contributed to rising rates of obesity and diabetes, prompting the introduction of the sugar-sweetened beverage tax, while industrial trans fats have also been restricted under Nigeria’s Trans Fatty Acid Regulation.
“These measures are designed to control dietary patterns that fuel the growing burden of non-communicable diseases, placing enormous pressure on health systems, national economies and household incomes,” he said.
Child malnutrition remains a concern
Mr Salako also highlighted the country’s persistent nutrition challenges, noting that malnutrition remains a direct or underlying cause of nearly half of the deaths among children under five years.
He said the Nigeria Mini Demographic and Health Survey found that about four in every 10 Nigerian children under five are stunted, while nearly two million children suffer severe acute malnutrition annually.
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“These are not merely health statistics. They represent profound human capital challenges with significant implications for educational attainment, labour productivity, household prosperity, national competitiveness and sustainable economic growth.”
Implementation key
Mr Salako stressed that the success of the guidelines would depend on effective implementation rather than their launch.
He urged procurement and accounting officers across government institutions to ensure compliance, noting that procurement decisions influence health outcomes, productivity and public confidence in government.
He added that the Federal Ministry of Health and Social Welfare would continue to promote disease prevention through healthier public policies as part of efforts to achieve universal health coverage.
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