Background: Menopause is the permanent cessation of menstruation seen in women
between 40-61 years of age. Menopause is characterised by reduction in ovarian
hormone production. Oestrogen deficiency and age related processes cause
decrease in calcium levels in post menopausal women.
Aims and Objectives: To study serum calcium levels in premenopausal
and post menopausal women.
and Methods: Cross
sectional study was conducted. 35 pre menopausal and 30 post menopausal women
were selected according to inclusion and exclusion criteria . Patients with medical
history of major systemic diseases, women on hormone replacement therapy, and
women who had surgical menopause were not included in the study .Serum calcium levels were estimated in
For statistical analysis the value of laboratory parameters were presented as
the Mean±SD (standard deviation). A Student’s t-test was used for cross-sectional
comparisons of continuous variables between the groups.
Results: Serum calcium levels were
significantly lower in post menopausal women than in pre menopausal women.
Conclusion: Post menopausal women are calcium
women , postmenopausal women ,Menopause
, serum calcium .
is permanent cessation of menstruation , seen in women between 40-61 years of
age .It is characterised by the menstrual changes that reflect oocyte depletion
and subsequent reduction in ovarian hormone production. Menopause typically
occurs in middle age , 40-61 years of age, signalling the end of the fertile
phases of life1 . Menopause is characterised by hot flushes, night
sweats and various other psychological and biochemical changes . It also leads
to metabolic bone disorders .With the onset of menopause , rapid bone loss
occurs which is believed to average 2 to 3 % over the following 5 to 10 years
,being greatest in the early post menopausal years 2,3 .Calcium ion
is an essential structural component of skeleton .Body cannot synthesize it
.Nutrition imbalance with endocrine
abnormalities may be involved in osteoporosis 4. Extracellular
calcium ion concentration is determined by the interaction of calcium absorption from intestine , renal excretion of
calcium and bone uptake and release of calcium , each of which is regulated by parathormone , vitamin D and calcitonin 5
. Estrogen deficiency is present in post menopausal women. Estrogen deficiency
results in longer life span of osteoclasts 6.This estrogen
deficiency is reason for osteoporosis seen after menopause .The female sex hormone
diminish to almost none after menopause .Bone turnover increases to high levels
in women soon after menopause . The 2 main causes of bone loss are estrogen
deficiency after menopause and age related process 7 . Intestinal
calcium absorption decreases in post menopausal women 8 .Osteoporosis
is a late complication of menopause.It is a degenerative bone disorder where
there is thinning and weakening of the bone and a general decrease in bone mass
and density .So susceptible to fractures .Fractures related to osteoporosis are
estimated to affect around 30% of women in developed countries and are a major
health problem.Normally bone will go through a process where old bone is
replaced by new bone cells .Our body’s ability to handle this process changes
with age. Estrogen is involved in the process of calcium absorption into the
bones .During menopause there is a drop in estrogen levels .All women will
experience acceleration in bone density reduction as their estrogen levels
drop. Menopause in elderly women is associated with accelerated loss of
cortical bone .Rapid bone loss occurs when the balance between formation and
resorption is upset resulting in a negative remodelling balance and leads to
osteoporosis. It is mainly due to imbalance in hormonal factors like estrogen,
prolactin and changes in bone formation markers like calcium, phosphorus .
The decrease in the level of sex steroid
hormones during menopause in women causes various somatic, vasomotor, sexual
and psychological symptom. The risk of osteoporosis, cardiovascular disease,
arterial hypertension, impairment of glucose metabolism, and degenerative
cognition disease incidence rises. The impact of deficiency of female sex
hormones after menopause on the trace minerals has not been widely studied but
expected menopause related changes in their status may have an impact on the
above pathologies. There are very
few reports on the changes in serum calcium and magnesium levels in various
phases of the menstrual cycle in otherwise healthy women. Estrogen induces
hypercalcemia through the action of the parathyroid gland. Withdrawal of
estrogen is reported to cause a significant loss of bone calcium. Increase in
serum calcium levels during the follicular and ovulatory phases could be due to
the effect of estrogen on the parathyroid glands. In addition to bone calcium
content the level of serum calcium appears to be associated with blood pressure,
and could be a metabolic risk factor for cardiovascular disease.
The study was carried out to evaluate calcium status in pre and post menopausal
Materials and Methods:
sectional study was conducted in 35 pre menopausal women ( 25-45 years of age)
and 30 post menopausal women(46-65 years of age) in department of Physiology.
Subjects were selected from general population according to the inclusion
criteria . Consent was taken from
subjects and procedure was explained to subjects.
criteria : Post menopausal women between
age 46-65 years.
criteria : 1) Surgical menopause due to
menopausal women on estrogen therapy
having Diabetes / Hypertension.
of blood sample 5 ml of venous blood was drawn aseptically from each subject .
It was centrifuged at 3000rpm for 10 minutes and serum was separated .Serum
calcium levels were estimated by photocolorimetry
t test was applied to see the
significance of difference of parameters
between 2 groups .Mean and standard deviation of variables was determined Correlation was done by using Pearson s
correlation coefficient. The interpretation of P value are as follow
>0.05 – not significant