Women in middle-age should not all be treated with the same bone-protection therapies, say researchers.
Aging and menopause are both causes of bone loss - but the underlying mechanisms are different, say researchers at the University of Michigan. They found that the impact of aging is minor compared to that of estrogen withdrawal after the menopause. This means that therapy for bone loss should be different at different points in a woman's life.

They compared a group of women aged 20 to 52 and age-matched women who either had, or had not, been through the menopause. The rate of bone turnover - that is, the rate at which the body replaces old bone with new - increases as a women reaches the menopause. But in menopause, the replacement is not as efficient and this leads to bone loss.

Pre-menopausal women - of whatever age - do not have accelerated bone turnover as they get older. So it is pointless to treat them with therapies, like HRT, which slow down bone turnover. These are best reserved for menopausal women. There are already health problems associated with hormone replacement therapy, so it should not be given to prevent age-related bone loss where bone turnover is not an issue.