Bone mineral density and follicle-stimulating hormone levels
Menopause-related loss of spine and hip bone mineral density (BMD) is linked to both low estradiol and higher follicle-stimulating hormone (FSH) levels, according to a cross-sectional study in the International Journal of Environmental Research and Public Health. The authors noted that estradiol is considered the most critical factor in menopause-associated decrease in BMD, but also that the role of increasing FSH during menopause is relatively unclear. For the study, 141 healthy women, aged 30 to 70 years, from Colorado were classified to 1 of 5 menopausal status groups based on self-reported menstrual cycle history: premenopausal (n = 30), early perimenopausal (n = 31), late perimenopausal (n = 30), early postmenopausal (n = 24), and late postmenopausal (n = 26).

Spine/hip BMD and sex hormones were measured on all women using dual-energy x-ray absorptiometry and enzymatic/colorimetric methods, respectively. Compared with early perimenopausal women, spine BMD was lower in late perimenopausal, early postmenopausal, and late postmenopausal women, whereas hip BMD was lower among early postmenopausal and late postmenopausal women.BMD also was inversely associated with FSH. In addition, BMD was directly associated with estradiol. The authors corroborate previous data indicating that menopause seems to be a vulnerable period for bone loss, even in healthy women.

The authors acknowledged that physical inactivity can exacerbate BMD decline and increase fracture risk; however, to determine whether menopause contributes to declines in physical activity after menopause requires a larger cohort study using a more accurate measure of physical activity, such as accelerometry.