Risks for Post-menopausal Bone Fractures

By Dr. Viktoriya Zabigaylo, ND

The transition through menopause often leads to certain health risks due to lower estrogen levels. Estrogen helps to keep blood vessels healthy, prevents bone loss, maintains skin hydration and elasticity, improves mitochondrial function and protects against oxidative damage. With the decline in estrogen that naturally happens after menopause, women are more likely to develop certain diseases including cardiovascular disease, metabolic syndrome, osteoporosis and bone fractures, mood disorders, and cognitive decline.

While menopause is inevitable, there are things we can do to manage and minimize symptoms, and focus on preventing disease in the post-menopausal years. This includes managing stress, getting good quality sleep, maintaining a healthy diet, and engaging in exercise that emphasizes muscle strength and balance. Supportive treatments such as nutrient supplementation and hormone replacement therapy can also be effective in many cases.

Blood sugar regulation is an important factor for overall metabolic and hormonal health. Recent research has shown that consistently having a blood glucose level in the pre-diabetic range before or during menopause is a risk factor for bone fractures after menopause. This is true even if women don’t actually develop diabetes, and regardless of their bone mineral density.

This study by Shieh et al. (2023) tracked female participants between the ages of 42-52 for about 16 years. Those who had prediabetes during half of that time period were 49% more likely to have a bone fracture after menopause, compared to women with no prediabetes. The participants who had prediabetes during that entire time period were 120% more likely to have a bone fracture after menopause.

In light of this evidence, it would be beneficial for women and their health care providers to start the conversation about post-menopausal bone health and disease risk in their 30’s and 40’s. In reality, this discussion usually occurs well after menopause, often after a bone fracture has already occurred. Addressing the impact of current health on menopause and beyond creates an opportunity to discuss prevention and begin implementing these practices. It is important that pre-menopausal women are well informed about their blood glucose status and the associated health consequences that arise from untreated prediabetes such as cardiovascular disease, and as we now know, increased risk of bone fractures.


Iorga A, et al. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biol Sex Differ. 2017; 8(33). doi:10.1186/s13293-017-0152-8

Jones, D. Prediabetes as an independent risk factor for bone fractures in women. Natural Medicine Journal. 2023.

Shieh A, Greendale G, Cauley J, Karvonen-Gutierrez C, Karlamangla A. Prediabetes and fracture risk among midlife women in the Study of Women’s Health Across the Nation,1980-2002. JAMA Network Open. 2023; 6(5): e2314835.

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