Prevention and treatment of osteoporosis during menopause: From physiological mechanisms to the gradual principle of scientific physical exercise
Osteoporosis can be caused by disuse, nutritional, and secretory factors, with menopausal osteoporosis falling into the latter category. After menopause, women experience a decline in ovarian function and sex hormone levels, leading to bone atrophy and accelerated bone resorption, resulting in osteoporosis. After menopause, bones lose their firmness and support, causing general weakness and aches. Pain is primarily felt in the spine and pelvis, but can radiate to the lower back and legs.
The pain worsens with activity and is relieved by bed rest, but worsens again upon standing after rest. Osteoporosis increases bone fragility, making fractures possible even with minor external forces. Common sites for fractures include the wrist, femoral neck, proximal humerus, and spine. If the lesion is in the spine, the primary pain is lower back pain. Intercostal neuralgia can also occur due to vertebral compression; pain can also occur in the lower part of the costal arch near the anterior iliac crest due to significant kyphosis of the thoracic and lumbar spine.
Pain can also be caused by strain on the muscles or ligaments of the lower back, or by spasms in the spinal muscles, the latter of which causes pain over a wider area. Osteoporosis itself does not directly cause pain or any other symptoms; therefore, any patient experiencing pain should be wary of a fracture. Sometimes, fractures can also occur indoors, such as in poorly lit living conditions, uneven floors, cluttered furniture, beds that are too high, excessive use of sedatives before bed, or temporary low blood pressure fainting and injury when getting up to defecate at night.
During a physical examination, the fracture site may be tender to percussion and pressure. If the patient only experiences pain without any fracture reaction, it is usually caused by factors other than osteoporosis. Men over middle age should actively participate in physical exercise and maintain consistency, such as walking, jogging, health massage, Baduanjin (Eight Pieces of Brocade), and Tai Chi, to help retain more calcium in the bones. In addition, they should regularly get sunlight outdoors and appropriately supplement their diet with foods and medications rich in protein, calcium, and various vitamins.
Treatment of postmenopausal osteoporosis can be divided into treatment of osteoporosis itself and treatment of complications caused by osteoporosis. Insufficient calcium intake is one of the causes of osteoporosis, therefore it is necessary to check calcium balance and administer large amounts of calcium to turn the negative balance into a positive balance. Milk can be consumed, and 1-1.5 grams of calcium phosphate or calcium lactate can be given daily. The maintenance calcium balance for patients is 17 mg per kilogram of body weight per day. Traditional Chinese medicine has the saying "the kidney governs bones and produces marrow," so using kidney-tonifying pills or marrow-tonifying pills may be helpful.
Participating in physical exercise is the most effective way to promote health and enhance wisdom. However, in reality, there is a widespread phenomenon of middle-aged men participating in less physical exercise. This is because many of them are key figures in their work, lives, and scientific endeavors, with heavy workloads and busy household chores, leaving them with insufficient time. The idea of waiting until retirement to exercise is clearly inappropriate. The mortality rate among middle-aged people is higher than that of the elderly, and 87% of middle-aged people suffer from various chronic diseases. Therefore, middle-aged people should pay attention to their health and strive to improve their physical fitness.
Physical labor promotes metabolism, absorbs oxygen and nutrients, eliminates waste, and slows down aging. Men going through menopause can choose light physical labor and housework, such as gardening, cooking, sweeping, and laundry, all of which are beneficial to their health. Over 80% of people over 80 years old are manual laborers, illustrating the importance of labor for health. Exercise provides excellent stimulation to the central nervous system and endocrine system, improves metabolism, activates oxidation processes, and is the best way for the brain to actively rest.
When engaging in physical exercise, it's essential to follow the principle of gradually increasing the intensity from small activities. This is because physical strength, endurance, and dexterity all improve gradually. The internal organs and their functions also require an adaptation process; one should not rush the process and should exercise only to the point of not causing fatigue. Regardless of the type of exercise, all muscles, bones, and joints must be worked. However, excessive exercise is detrimental to health, easily leading to fatigue and even damage to internal organs or the body.