Risk Assessment for Postmenopausal Women

Am I postmenopausal?

You are postmenopausal if you have had permanent loss of your monthly periods. Permanent loss of your monthly periods is considered not menstruating for 12 months in a row without another medical reason. Menopause may occur naturally, usually between the ages of 45 and 55, or following surgical removal of both ovaries. If you are still having menstrual periods, use the “Osteoporosis Risk Assessment for Premenopausal Women“.

Who is at risk for osteoporosis?

Osteoporosis is a silent disease that causes bones to become thin and weak, often resulting in broken bones. It can happen to anyone; the disease has no age, gender or ethnic boundaries. Osteoporosis more commonly affects older, postmenopausal women, and individuals of Caucasian or Asian descent. This does not mean that others are not at risk for osteoporosis. Men, African-Americans and other populations get osteoporosis, too; they are just at a slightly lower risk than Caucasian or Asian postmenopausal women.

Why is it important to know my risk factors?

It is important for you to identify your personal risks for osteoporosis. Knowing your risk factors is the first step in taking an active role in the prevention, early diagnosis, and treatment of osteoporosis.

Risk Assessment for Postmenopausal Women PDF small print
Risk Assessment for Postmenopausal Women PDF large print

Am I at risk for osteoporosis?

You may be at risk for osteoporosis if you answer “yes” to many of the risk factors that follow. The more risk factors that you check, the greater your risk for osteoporosis.

Check () if you…

are postmenopausal
have had an early menopause at age 45 or younger (naturally occurring or following surgery to remove your ovaries)
are age 65 or older (the older you are, the greater the risk)
are Caucasian or Asian
are small and thin
have a parent who has/had osteoporosis or a broken hip
have a personal history of low-impact fractures (broken bones) without trauma, such as a car accident or severe sports injury) during adulthood, x-ray evidence of spine fracture, height loss of more than 1-1/2 inches or stooped posture
have a history of a temporary loss of monthly periods for more than 12 months before your menopause or infrequent periods for several years before your menopause (excluding the time during pregnancy or breastfeeding)

Check if you have any of the following chronic diseases/conditions often associated with osteoporosis:

autoimmune disease including lupus
blood disorders – certain types such as leukemia, sickle cell disease
cancer – certain types such as breast, lymphoma, various metastatic , multiple myeloma, ovarian
eating disorders – anorexia, bulimia
hyperparathyroidism (excessive parathyroid hormone)
hyperthyroidism (excessive thyroid hormone)
inflammatory bowel disease
kidney disease
immobility or bed rest for more than 6 months
liver disease
lung disease that is chronic (COPD)
malabsorption- from bariatric (obesity) surgery, celiac disease, Crohn’s disease, liver disease, pancreatic disease
neurological disorders – such as multiple sclerosis, Parkinson’s disease, spinal cord injury, stroke
organ transplant
rheumatoid arthritis

Check if you are taking or have taken any of the following medications:

Important: If you take any of these medications, do not stop or change the way you take them without medical advice
from your healthcare provider.

aluminum containing antacids – such as Maalox or Mylanta taken for long periods of time
antiseizure medications – only some such as Dilantin (phenytoin) or phenobarbitol
aromatase inhibitors – such as Arimidex, Aromasin, Femara
blood-thinning agents – such as long-term use of warfarin (Coumadin) or heparin
chemotherapy- some types
diabetes medications: some known as thiazolidinediones (TZDs) such as Actos, Avandia
gonadotropin-releasing hormone agonists (GnRH)- such as Lupron and zoladex used to treat endometriosis
immunosuppressants – cyclosporine A, methotrexate, FK506 (Tacrolimus)
proton pump inhibitors (PPIs) – such as Nexium, Prevacid, Prilosec
selective serotonin reuptake inhibitors (SSRIs)- such as Lexapro, Paxil, Prozac, Zoloft
steroids (such as prednisone or cortisone) in a dose of 5 mg or more taken for 3 or more months
thyroid medications taken in excess or lack of routine bloodwork to check TSH levels

Check if you have a longterm history of any of the following lifestyle risk factors:

low calcium intake- eating few, if any dairy foods or foods with calcium added and not taking calcium supplements
low vitamin D intake – seldom eat fatty fish or milk and take no multivitamin or vitamin D supplement
little physical activity – such as less than 60 minutes per week
smoking – more than 1 pack a day for more than 5 years or current smoking in any amount
excessive alcohol intake or alcohol abuse

Although risk factors may increase your likelihood of getting osteoporosis, having risk factors does not mean that you have or will get the disease. Only a bone mineral density (BMD) test can diagnose osteoporosis. It is important to be aware that the above checklist of risk factors is not complete. There are additional conditions and medications that may cause bone loss leading to osteoporosis; some of which are known as well as others that have not yet been identified. Postmenopausal women who do not have any of the above risk factors for osteoporosis may not be protected from developing this disease. Risk assessment should increase your awareness of the potential for osteoporosis and motivate you to follow the steps to promote strong bones.

What is important to discuss with my healthcare provider?

Bone mineral density (BMD) testing is recommended for all women aged 60 or older and for younger postmenopausal women with risk factors for osteoporosis. To have a BMD test, a prescription from a healthcare provider is necessary. It is recommended that you speak to your healthcare provider to discuss your risk for osteoporosis and to find out when the right time is for you to have a BMD test.