KATHMANDU, Jan 15: As people age, both men and women experience weakening of bones and joints. However, doctors note that women tend to face these problems earlier than men—a trend confirmed by both national and international data.
A 2025 report by the Orthopedics Department of Nepal Police Hospital shows that post-menopausal women seeking treatment experience a significant drop in bone density, leading to osteoporosis. Among women treated from January to December 2024, 71.95% were diagnosed with osteoporosis. Out of 82 women, 59 had the condition, confirmed through DEXA scans.
At Civil Hospital’s Orthopedics Department, 70% of patients are women, while men make up 30%. Men usually come for injuries or nerve compression issues, whereas women often seek care for bone-related problems, explains orthopedic surgeon Dr. Parimal Acharya.
Women visiting doctors often report joint pain, worn knees, chronic back pain, bone fractures, neck pain, and spinal pain. Among these issues, osteoporosis is the most common. Doctors highlight that the condition is widespread among Nepalese women.
Osteoporosis can make even minor injuries painful, and in some cases, falls can lead to fractures—or even death. “At this hospital, 90% of knee replacement surgeries are performed on women, while only 10% are on men,” Dr. Acharya notes.
Nerve compression problems are also more common among women, particularly those with thyroid issues, and tend to start around age 45.
Menopause and estrogen deficiency increase risk
From the onset of menopause, women’s estrogen levels gradually decline. Estrogen helps maintain bone strength; when it decreases, calcium is lost from the bones, making them porous—a condition known as osteoporosis. This can lead to fractures in the spine and vertebrae, and many women also experience a reduction in height. Post-menopause, bones continue to weaken.
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Nutrition deficiency
Poor nutrition is another factor. Nepalese diets are often high in carbohydrates but low in calcium and protein, essential for strong bones. “Due to nutritional deficiency, women start facing bone and joint problems after 50, while men encounter such issues only after 70,” says Dr. Acharya.
Body structure
Women’s body structure also plays a role. A wider pelvis and a pelvis angle over 80 degrees mean more weight is placed on the lower body, which can strain muscles and joints. Weak muscles around the pelvis transfer stress to knees and hips, accelerating joint wear.
Genetics
Heredity influences bone and joint problems as well. If a mother or grandmother had bone-related issues, the next generation is likely to face them. Weak joint ligaments make women’s joints more vulnerable to wear compared to men.
Obesity and lifestyle
Lifestyle contributes significantly. Women often perform more household chores, which involve bending, standing, and moving, but these activities do not strengthen bones and may contribute to weight gain. A sedentary lifestyle, unbalanced diet, and lack of exercise further weaken bones. Excess weight increases strain, accelerating wear.
Chronic diseases
Medications such as steroids used for chronic illnesses may also affect bone health. While they may alleviate conditions like asthma, long-term use can weaken bones.
How to protect bones
Even after menopause, estrogen is not completely gone. Women are encouraged to engage in regular, moderate exercise, such as walking or aerobics, to maintain bone strength.
Nutrition
A balanced diet rich in protein, calcium, and micronutrients is essential. Regular consumption of these foods helps keep bones strong.
Chronic disease management
Women with chronic illnesses should follow medical guidance carefully. Steroid use may weaken bones, so preventive care, proper diet, and exercise from a young age are key.
Weight and exercise
Maintaining a healthy weight reduces stress on bones. Doctors recommend a balanced diet and regular exercise to control weight. Adopting a healthy lifestyle before age 35 can help preserve bone strength.
Preserving the uterus
The trend of early hysterectomy is rising. Removing the uterus too soon can weaken bones. Doctors suggest keeping the uterus and ovaries until at least age 55.
Maintaining strong bones
To strengthen bones, doctors advise including vitamin B, calcium, and protein-rich foods in daily meals, participating in sports in youth, and maintaining regular, balanced exercise. Even post-menopause, some estrogen is produced by body fat, which helps maintain bone strength. Therefore, women are advised to maintain a small amount of body fat rather than becoming too thin, as this supports hormone production that protects bones.
