Dr. Betty Murray explains how menopause disrupts the hormonal balance that builds bone, causing rapid breakdown in the first five years. Gut bacteria produce short-chain fatty acids that regulate bone loss, so when these decline alongside hormones, bone deteriorates faster. Increased gut inflammation and intestinal permeability can accelerate bone loss, especially in people with autoimmune conditions.
Well, we know within the first 5 years of menopause, that's when we lose the bulk of, that's when we really start upregulating this bone breakdown. And both progesterone and estradiol are designed to, you know, it's like a seesaw, it's all about balancing. Estradiol is bone building, progesterone is bone breakdown, and it's designed to balance each other out. But what starts to happen and unwind in the setting of less hormones, we get more bone breakdown than we do bone buildup. And so that's what we're dealing with, especially in that first 5 years of menopause, But what's interesting is these short-chain fatty acids actually control osteoclastic activity. So in the setting of less short-chain fatty acids, less hormones, we're getting an acceleration in this bone breakdown. And I think a lot of people don't think about that connection between the gut and the bone, but it's actually the gut-bone axis. So, you know, more inflammation in our bodies, worsening insulin sensitivity, leaky gut is leaky bone. Leaky gut is also leaky brain. And so I remind people, um, if you've got an autoimmune condition, you're probably at risk for bone loss. And we really have to think about it in a very systematic manner and not think about it in that traditional siloed allopathic medicine model, which I always say, if it's an emergency or an urgency, we do a better job than anybody else.
