Osteoporosis in Women
|What is Osteoporosis?
Osteoporosis is a disease in which the bones of the body become brittle making them easier to fracture (a fracture means the same thing as a break). The hips, spine and wrist are usually the first to break. Osteoporosis gradually weakens the bones so that they become susceptible to the slightest trauma. As the loss of bone strength takes place over many years, there may be no immediate obvious symptoms. Often the first danger sign is a bone fracture, which is why osteoporosis is often referred to as the 'silent epidemic'. Research shows that around 40 percent of women and 10 percent of men in America today are likely to develop osteoporosis later in life. Every year it causes 700,000 spine fractures and 250,000 wrist fractures in the United States. As nearly 20 percent of people with spine fractures sustain another fracture within a year, prevention and early detection of the condition is important. Fortunately it is a preventable and treatable disease.
The World Health Organization (WHO) defines osteoporosis as a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture.
Symptoms of osteoporosis: As osteoporosis is known as the 'silent' disease, it can develop quietly over many years without producing symptoms. The most common first sign is a broken bone, usually in the hip or wrist. If bones have weakened, sometimes all it takes is an abrupt halt or stepping off a curb to fracture the hip. A vertebrae (back) fracture can occur from something as simple as everyday walking or a coughing fit. A fracture which occurs as a result of normal activity is known as a fragility fracture. Fragility fractures sometimes go unnoticed but they can cause a chronic dull ache in the affected area (which the person may attribute to something else, like a strain).
Loss of height or stooping is a longer term problem. Often compression fractures of the spine can go undetected or may be attributed to a back strain injury. The more vertebral fractures you have, the more you are likely to develop. As each vertebra is injured the spine is squashed and compressed into a smaller height. This can eventually give the appearance of a stoop or hunched back (known as dowager's hump, image).
Scientists are still not 100 percent sure of the causes of osteoporosis. Bone mass decreases in women naturally between 1 to 5 percent every year after the age of 40. This rate is only about 1 percent in men. Our bones are continually changing, old bone is broken down (and absorbed into the blood stream) and new bone is created. As we age this process (called the 'remodeling' process) becomes less efficient and we lose more than we gain. This weakens the bones, which become porous and more fragile. Hormones are another contributory factor. The sudden drop in estrogen (which is instrumental in building healthy bone tissue) around menopause contributes towards osteoporosis by preventing the absorption of calcium and phosphates - both essential bone making ingredients. Reduced testosterone in men, normally much later in life has the same effect. Other potential causes include chronic rheumatoid arthritis, eating disorders, chronic kidney disease, prolonged best rest, hyperparathyroidism and certain drugs.
There are many risk factors that can contribute towards a person developing osteoporosis. Some of these are:
1. Most postmenopause women are candidates for osteoporosis.
There are generally two types of women who should test for osteoporosis. The first group is postmenopausal women in their 50s who want to know the status of their bones. The second are women who have experienced symptoms, such as a fracture or reduced height. Most hospitals have facilities for testing bone density (see: osteoporosis diagnosis). The fastest and safest of these is a DEXA scan (image). A CT scan can also be used, but it is generally more expensive and exposes the patient to more radiation. If bone loss is detected and osteoporosis is suspected, other potential causes have to be ruled out first. Expect a medical examination, blood and urine tests.
Generally an osteoporosis treatment plan aims to prevent further degeneration of bones and even to increase bone density. Until bisphosphonate drugs were introduced there was no known way to prevent or reverse bone loss. Bisphosphonates appear to even increase bone density. Estrogen replacement therapy (ERT) appears to have benefits in improving calcium absorption and reducing the amount excreted by the body. Other drugs used for treating osteoporosis include SERMs, including tamoxifen (also used for treating breast cancer); and parathyroid hormone (brand name Forteo) which appears to double the rate of bone formation. Anabolic steroids, growth hormones and vitamin D analogs (calcitriol) which may stimulate bone formation are still in the research stage.
Osteoporosis Prevention: The best way to prevent osteoporosis is to maximize bone density during our growth years - ideally during adolescence and the 20s. However it is never too late to start. Before menopause osteoporosis is best prevented by following a diet rich in calcium and vitamin D and by carrying out weight-bearing exercise. The same applies after menopause but more nutrients may be required and more care given to the type of exercise carried out.
| Other Useful Guides
Recommended Health Screenings For Women: List for all generations.
Return to Homepage: Womens Health Advice