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VOLUME 5 , ISSUE 2 ( July-December, 2017 ) > List of Articles


Osteoporosis in Black South African Women: Myth or Reality

Lineo Matsela, Olakunle Towobola, Ephraim T Mokgokong

Citation Information : Matsela L, Towobola O, Mokgokong ET. Osteoporosis in Black South African Women: Myth or Reality. J South Asian Feder Menopause Soc 2017; 5 (2):111-116.

DOI: 10.5005/jp-journals-10032-1118

License: CC BY 3.0

Published Online: 01-01-2011

Copyright Statement:  Copyright © 2017; The Author(s).



The study was conducted to ascertain the severity of the occurrence of osteopenia and osteoporosis among black South African women during their transition from premenopause to postmenopause.

Materials and methods

Sixty-eight black South African women, aged between 32 and 77 years, residents of three districts of Pretoria, South Africa, constituted the participants in the study. Following informed consent, the women were randomly recruited and assessed for age, medical history, and lifestyle data. Each woman was classified as being premenopause, perimenopause, or postmenopause based on her menstrual history within the preceding 12 months to the study. Bone mineral density (BMD) of the L1-L4 vertebrae and the hip vertebrae was measured using dual-energy X-ray absorptiometry (DEXA) method and the results were expressed as T-scores based on World Health Organization (WHO) classifications for osteopenia and osteoporosis.


Osteopenia was found in 2 of the 8 (25%) premenopausal women aged 37 and 38 years. Similarly, 2 perimenopausal women out of the 28 (7.1%), aged 45 and 49 years, also had evidence of osteopenia. Among 32 postmenopausal women, 11 (34.4%) had osteopenia and 8 (25%) were diagnosed with osteoporosis. There was no statistical significant difference (p = 0.0832) for osteopenia between premenopausal and perimenopausal women. However, the incidence of osteopenia became statistically significant between premenopausal and postmenopausal women (p = 0.0137), and between perimenopausal and postmenopausal women (p = 0.0218).


Even from this small cohort study, it is apparent that osteoporosis does afflict postmenopausal black South African women. The need to institute screening strategies and appropriate guidance to prevent osteoporosis in these women is strongly advocated.

Clinical significance

The study draws special attention to the necessity to investigate black South African women for early detection of osteopenia and osteoporosis.

How to cite this article

Matsela L, Towobola O, Mokgokong ET. Osteoporosis in Black South African Women: Myth or Reality. J South Asian Feder Menopause Soc 2017;5(2):111-116.

Source of support

The authors herewith express their gratitude to both MSD (South Africa) and the South African Menopause Society for their financial donations, which enabled the DEXA evaluations of participants in this study.

  1. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001 Feb 14;285(6):785-795.
  2. Epidemiol Rev 1985;7:178-208.
  3. Clinical spectrum. In:Riggs BL, Melton LJ, editors. Osteoporosis: aetiology, diagnosis, and management. New York (NY): Raven Press; 1988. p. 155-179.
  4. Osteoporosis in developing countries. J Best Pract Res Clin Rheumatol 2008;22(4)693-708.
  5. Report of a WHO Scientific Group — Prevention and management of osteoporosis. World Technical Report Series 921; 2003.
  6. Bone mineral density changes during the menopause transition in a multiethnic cohort of women. J Clin Endocrinol Metab 2000 Mar;93(3):861-868.
  7. Comparison of body composition in black and white premenopausal women. J Lab Clin Med 1997 Mar;129(3):294-299.
  8. Body elemental composition: comparison between black and white adults. Am J Physiol 1977 Apr;232(4):E419-E422.
  9. The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone 2005 Oct;37(4):474-481.
  10. Body composition in normal black women: the four-compartment model. J Clin Endocrinol Metab 1996 Jun;81(6):2363-2369.
  11. Cortical bone histomorphometry of iliac crest in normal black and white South Africans. Calcif Tissue Int 2006 Dec;79(6):373-382.
  12. Osteoporosis and fracture of the femoral neck in the South Africa Bantu. J Bone Joint Surg Br 1968 Feb;50(1):B2-B12.
  13. Diseases in urban and rural Black populations. S Afr Med J 1977 Jan 29;51(5):121-123.
  14. Changes in markers of bone turnover following urbanisation of Black South African women. SAJCN 2003;16:104-108.
  15. Urbanization of black South African women may increase risk of low bone mass due to low vitamin D status, low calcium intake, and high bone turnover. Nutr Res 2011 Oct;31(10):748-758.
  16. Physical inactivity as a risk factor for cardiovascular disease in communities undergoing rural to urban transition: the THUSA study. Cardiovasc J S Afr 2003 Jan-Feb;14(1):16-23.
  17. Osteoporosis: prevalence in Taiwanese women. Osteoporos Int 2004 Apr;15(4):345-347.
  18. Effect of urbanization on bone mineral density: a Thai epidemiological study. BMC Musculoskelet Disord 2005 Feb 4;6:5.
  19. Influence of parity on bone mineral density and peripheral fracture risk in Moroccan postmenopausal women. Maturitas 2007 Aug 20; 57(4):392-398.
  20. Bone mineral density among postmenopausal Saudi women. Saudi Med J 2004 Nov;25(11):1623-1625.
  21. Correlates of bone mineral density among postmenopausal women of African Caribbean ancestry: Tobago women's health study. Bone 2008 Jul;43(1):156-161.
  22. Osteoporosis preventive care in white and black women in community family medicine settings. South Med J 2007 Jul;100(7):677-682.
  23. Disparities in osteoporosis screening between at-risk African-American and white women. J Gen Intern Med 2005 Sep;20(9):847-851.
  24. African-American women: health beliefs, lifestyle, and osteoporosis. Orthop Nurs 2007 Mar-Apr;26(2):96-101.
  25. Evaluation of decision rules for identifying low bone density in postmenopausal African-American women. J Natl Med Assoc 2004;96(3):290-296.
  26. Risk factors for osteoporosis in postmenopausal African-American women. Curr Med Res Opin 2004 Oct;20(10):1681-1687.
  27. Osteoporosis screening is unjustifiably low in older African-American women. J Natl Med Assoc 2004 Apr;96(4):461-467.
  28. Bone density in an ageing Caucasian and African populations. Lancet 1979 Dec 22-29;2(8156-8157):1326-1330.
  29. Cut-off values of distal forearm bone density for the diagnosis of central osteoporosis in black postmenopausal South African women. J Endocrinol Metabol Diabet S Afr 2012;17(2)65-112.
  30. Ethnic differences and bone density and vertebral fracture prevalence between black and white South African females. JEMDSA 2005;10(1):40-45.
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