A consultant obstetrician and gynaecologist, Dr Taiwo Tsele, has warned that millions of Nigerian women face an increased risk of osteoporosis after menopause, urging early screening and lifestyle changes to prevent fractures, disability, and loss of independence in old age.
Tsele gave the warning at the inaugural meeting of The Osteoporosis Care Network (TOCAN) 2026, convened by First Health Dynamic Synergy International in Ibadan.
Speaking on ‘Women, menopause and bone health’, she described osteoporosis as a silent disease that often goes undetected until a fracture occurs, explaining that the sharp decline in oestrogen after menopause accelerates bone loss.
Findings from one of Nigeria’s largest osteoporosis studies, conducted at the University College Hospital (UCH), Ibadan, involving 2,401 older adults, reported that 65.2 per cent of older women had osteoporosis compared with 43.7 per cent of men, highlighting the greater burden among women.
Presenting the findings, Dr Lawrence Adebusoye said, ‘Our findings showed that nearly two out of every three older women had osteoporosis severe enough to place them at significant risk of fractures. Although women are more affected, the prevalence among men is also substantial and should not be overlooked.’
According to Tsele, many Nigerian women endure menopausal symptoms in silence because they regard menopause as a normal part of ageing and rarely seek medical attention.
‘In our environment, many women believe menopause is something they must simply endure. They experience symptoms such as vaginal dryness, hot flushes, sleep disturbances and mood changes, but hardly seek medical attention. Unfortunately, they also remain unaware that menopause significantly increases their risk of osteoporosis,’ she said.
She explained that oestrogen regulates bone breakdown and formation. As hormone levels fall after menopause, bone breakdown outpaces bone formation, leading to rapid bone loss and increased fracture risk.
‘You don’t feel osteoporosis. Most women only discover they have it after a simple fall results in a fracture of the hip, spine or wrist,’ she added.
Tsele identified advancing age, early menopause, family history, and female sex as major non-modifiable risk factors, while smoking, excessive alcohol intake, physical inactivity, poor calcium intake, and prolonged steroid use further increase the risk.
She urged women to adopt regular weight-bearing exercise, consume adequate calcium and vitamin D, and maintain healthy nutrition, stressing that strong bones are built from childhood.
She also expressed concern over poor access to osteoporosis screening in Nigeria, noting that many women cannot afford bone mineral density tests despite recommendations that women aged 65 years and above, as well as younger postmenopausal women with risk factors, should be screened.
She described the Dual-Energy X-ray Absorptiometry (DEXA) scan as the gold standard for diagnosing osteoporosis and recommended wider use of the Fracture Risk Assessment Tool (FRAX) to identify high-risk individuals before fractures occur.
According to Tsele, the newly inaugurated Osteoporosis Care Network will promote awareness, strengthen multidisciplinary care and advocate national guidelines on osteoporosis prevention, screening and treatment.
‘The best treatment for osteoporosis is preventing the first fracture. If we educate women, identify those at risk early, and promote healthy lifestyles, we can significantly reduce the burden of osteoporosis in Nigeria,’ she said.
Also speaking, physiotherapist Dr Nse Odunaiya described exercise as one of the most effective and affordable ways to prevent and manage osteoporosis, noting that structured, professionally prescribed exercise delays age-related decline and improves physical, emotional, and mental wellbeing.
She advocated regular weight-bearing exercise, healthy lifestyles, and the reintroduction of physical education in schools, but cautioned against high-impact activities such as heavy weightlifting, rock climbing, and exercises involving sudden bending in people with fragile bones.
‘Exercise must be regular. Once people stop exercising, they gradually lose the benefits they have gained. It has to become a lifelong habit,’ she said.
Family physician and clinical nutritionist, Dr Yemisi Folasire, urged women to adopt healthy eating habits early in life, stressing that adequate calcium intake before the age of 30 is essential for achieving peak bone mass.
‘The cheapest and most effective way to prevent osteoporosis is to build strong bones early in life. If calcium intake is not adequate before menopause, women are likely to lose bone much faster later in life,’ she said.
She encouraged balanced diets rich in vegetables, fruits, and protein, recommended processed bean products such as moin moin and gbegiri to improve calcium availability, and emphasised that calcium should be taken alongside vitamin D, magnesium, and vitamin K for effective absorption.
Folasire also recommended flaxseed and chia seeds as healthy sources of fibre and omega-3 fatty acids, supported appropriate supplementation for high-risk groups, and advised reducing saturated fat intake while making healthier dietary choices.
According to her, improving nutrition throughout life, alongside regular exercise and supplementation where necessary, remains the most effective strategy for preventing osteoporosis and promoting healthy ageingocrinologist Dr Joko Adeleye warned that undiagnosed vitamin D deficiency significantly worsens osteoporosis by reducing calcium absorption, accelerating bone loss and increasing fracture risk.
‘Vitamin D is central to calcium homeostasis. When vitamin D levels fall, calcium absorption from the intestine decreases, and this has direct consequences for bone health,’ she said.
She explained that prolonged deficiency causes osteomalacia in adults and rickets in children. At the same time, many people with osteoporosis remain unaware of inadequate vitamin D levels because they often have no obvious symptoms.
Adeleye identified older adults, postmenopausal women, people with darker skin, limited sunlight exposure, malabsorption syndromes, chronic liver or kidney disease, pancreatic disorders and long-term corticosteroid users as groups requiring closer monitoring for vitamin D deficiency.