Gynaecological and Reproductive Risk Factors of Vertebral Osteoporosis

Menopause plays an important role in skeletal loss among aging female population. The aim of this study was to determine the role of gynaecological and reproductive risk factors in vertebral osteoporosis. Data on gynaecological and reproductive history were collected, (together with data of other risk factors, as a part of a larger study) using an interviewer administered questionnaire in urban randomised population of women age 50 and above. One hundred and sixty nine women were interviewed. Questions included: age at menarche, use of oral contraceptive pills, age at natural menopause, age at hysterectomy and/or ovariectomy, use of female sex hormones around or after menopause (more than 1 year), number of pregnancies. A lateral radiograph of dorsal and lumbar spine was taken. The films were read in a way that 6 points for each vertebra were placed to denote anterior, middle and posterior heights. The McCloskey and Kanis' morphometric method was used and 3 SD cut-off point was chosen for vertebral deformities. Fractures of some other sites that subject had after the age of 50 and which were the consequence of mild or no trauma, were also taken into account as presumably they have an osteoporotic background, too. Using the above mentioned morphometric method 19 women were found to have vertebral deformities (group VD) and 3 more having osteoporosis based fracture of some other site (group OF). No statistically significant correlation was found between either group VD or group VD+OF with age at menarcheee, age at natural menopause, age when period stopped, use of female sex hormones, use of OCP, and number of pregnancies. The significant result was a positive correlation between groups VD and VD+OF with duration of menopause (for both p < 0.01). Although the sample was small, as well as prevalence of certain risk factors, our findings suggest that duration of menopause is a significant risk factor of osteoporosis. Therefore is of great importance to use all possible tools to stop that time dependent postmenopausal bone loss.