As we go through menopause, we need to be vigilant about a silent stalker that lurks, just waiting to steal something you really value. No, I’m not talking about a purse-snatcher. I’m talking about osteoporosis, which weakens your bones and increases the risk of fractures.

The Cleveland Clinic reported, “There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. After menopause, bone resorption (breakdown) outpaces the building of new bone. Early menopause (before age 45) and any prolonged periods in which hormone levels are low and menstrual periods are absent or infrequent can cause loss of bone mass.”

The Cleveland Clinic identified important risk factors for this disease. These factors include:

• Age. Bone mass begins to naturally decline with age starting in your 30s.
• Gender. Women are four times more likely to have this disease than men.
• Race. Caucasians and Asian women have been found to have a tendency to develop osteoporosis. Hip fractures are twice more likely to occur in Caucasian women than in black women, although black women are more likely to die after a hip fracture.
• Bone structure and body weight. This is one time when a larger frame or more body weight can be beneficial. It turns out that petite and thin women (as well as small-boned, thin men) have a greater risk of developing this disease because they have less bone to lose.
• Family history. This happens to be one of the more important risk factors.

You may not be aware that you’re experiencing this bone loss until you break a bone or vertebrae due to a bump or fall. However, there is an accurate test – the bone mineral density (BMD) test – that can identify bone health issues. This test involves x-rays that use tiny amounts of radiation to determine bone density and assess any existing osteoporosis. You should have a bone mineral density test if you are under the age of 65 and have at least one risk factor. In addition, all post-menopause women who suffer a fracture should be tested, as should all post-menopausal women who are 65 years old and above.

Treatments for osteoporosis include calcium and vitamin D supplements, estrogen therapy, various medications, and weight-bearing exercises. (Of these options, I personally would start with the supplements and exercises since there have been concerns reported about some osteoporosis drugs.)

So what can you do to avoid osteoporosis? “The most important exercise for your bones is developing and maintaining good posture. No amount of exercise will undo 16 hours of bad posture a day,” Linda M. Burdette wrote for The North American Menopause Society. “Think about sitting and standing as tall as possible, pulling your belly button towards your spine, lowering your shoulders, and gently drawing your shoulder blades together. Place a mirror in a location where you will see yourself frequently so you will be reminded if you start to slouch.”