Menopause Threatens Millions of Nigerian Women with Osteoporosis — Gynaecologist Warns

The Growing Osteoporosis Crisis Among Nigerian Women

Dr. Taiwo Tsele, a consultant obstetrician and gynaecologist, has raised urgent concerns about the rising risk of osteoporosis among millions of Nigerian women following menopause. She emphasized the importance of early screening and lifestyle modifications to prevent fractures, disability, and loss of independence in old age.

Tsele delivered her warning at the inaugural meeting of The Osteoporosis Care Network (TOCAN) 2026, organized by First Health Dynamic Synergy International in Ibadan. During a session titled “Women, Menopause and Bone Health,” she highlighted that osteoporosis is often referred to as a silent disease because it typically goes unnoticed until a fracture occurs. She explained that the sharp drop in estrogen levels after menopause accelerates bone loss, making women particularly vulnerable.

A significant study conducted at the University College Hospital (UCH), Ibadan, involving 2,401 older adults revealed alarming statistics: 65.2% of older women had osteoporosis, compared to 43.7% of men. Dr. Lawrence Adebusoye, who presented the findings, noted that nearly two out of every three older women were at high risk of fractures due to severe osteoporosis. Although women are more affected, he stressed that the prevalence among men should not be ignored.

According to Tsele, many Nigerian women endure menopausal symptoms without seeking medical attention, viewing menopause as a natural part of aging. Symptoms such as vaginal dryness, hot flushes, sleep disturbances, and mood changes often go unaddressed. This lack of awareness contributes to an increased risk of osteoporosis, which remains undetected until a fracture occurs.

She explained that estrogen plays a crucial role in regulating bone breakdown and formation. As hormone levels decline after menopause, the rate of bone loss increases, leading to weakened bones and higher fracture risk. “You don’t feel osteoporosis,” she said. “Most women only discover they have it after a simple fall results in a fracture of the hip, spine, or wrist.”

Tsele identified several non-modifiable risk factors for osteoporosis, including advancing age, early menopause, family history, and female sex. Additional modifiable risks include smoking, excessive alcohol consumption, physical inactivity, poor calcium intake, and prolonged use of steroids.

To mitigate these risks, she urged women to adopt regular weight-bearing exercise, consume adequate calcium and vitamin D, and maintain healthy nutrition. “Strong bones are built from childhood,” she emphasized.

Access to Screening and Awareness

Despite recommendations that women aged 65 and above, as well as younger postmenopausal women with risk factors, should undergo screening, Tsele expressed concern over limited access to osteoporosis testing in Nigeria. Many women cannot afford bone mineral density tests, which are essential for early detection.

She described the Dual-Energy X-ray Absorptiometry (DEXA) scan as the gold standard for diagnosing osteoporosis and recommended the wider use of the Fracture Risk Assessment Tool (FRAX) to identify high-risk individuals before fractures occur.

The newly launched Osteoporosis Care Network aims to raise awareness, strengthen multidisciplinary care, and advocate for national guidelines on osteoporosis prevention, screening, and treatment. “The best treatment for osteoporosis is preventing the first fracture,” Tsele said. “If we educate women, identify those at risk early, and promote healthy lifestyles, we can significantly reduce the burden of osteoporosis in Nigeria.”

Exercise and Nutrition as Key Strategies

Physiotherapist Dr. Nse Odunaiya emphasized the importance of exercise in preventing and managing osteoporosis. She described structured, professionally prescribed exercise as one of the most effective and affordable ways to delay age-related decline and improve overall wellbeing.

Odunaiya advocated for regular weight-bearing exercises, healthy lifestyles, and the reintroduction of physical education in schools. However, she cautioned against high-impact activities like heavy weightlifting, rock climbing, and sudden bending, especially for those with fragile bones. “Exercise must be regular. Once people stop exercising, they gradually lose the benefits they have gained. It has to become a lifelong habit,” she said.

Family physician and clinical nutritionist Dr. Yemisi Folasire urged women to adopt healthy eating habits early in life. She stressed that adequate calcium intake before the age of 30 is essential for achieving peak bone mass. “The cheapest and most effective way to prevent osteoporosis is to build strong bones early in life,” she said.

Folasire encouraged balanced diets rich in vegetables, fruits, and protein. She recommended processed bean products such as moin moin and gbegiri to improve calcium availability and emphasized that calcium should be taken alongside vitamin D, magnesium, and vitamin K for effective absorption.

She also highlighted flaxseed and chia seeds as healthy sources of fiber and omega-3 fatty acids. Folasire supported appropriate supplementation for high-risk groups and advised reducing saturated fat intake while making healthier dietary choices.

The Role of Vitamin D in Bone Health

Endocrinologist Dr. Joko Adeleye warned that undiagnosed vitamin D deficiency worsens osteoporosis by reducing calcium absorption and accelerating bone loss. “Vitamin D is central to calcium homeostasis,” she said. “When vitamin D levels fall, calcium absorption from the intestine decreases, and this has direct consequences for bone health.”

Adeleye explained that prolonged deficiency causes osteomalacia in adults and rickets in children. Many people with osteoporosis remain unaware of their inadequate vitamin D levels because they often have no obvious symptoms.

She identified specific groups requiring closer monitoring for vitamin D deficiency, including older adults, postmenopausal women, people with darker skin, limited sunlight exposure, malabsorption syndromes, chronic liver or kidney disease, pancreatic disorders, and long-term corticosteroid users.