Osteoporosis is a common bone disease that affects almost 28 million Americans – 80% of those cases are women. It is a condition that can develop at any age, though it is mostly associated with the elderly.

During childhood and teenage years, new bone is added faster than old bone is removed. As a result, bones become larger and more solid. Bone formation continues until peak bone mass (maximum bone density and strength) is reached around age 30. After age 30, bone loss exceeds bone formation.

Osteoporosis develops when bone loss occurs too quickly, or if replacement occurs too slowly.
For women, bone loss is most rapid in the first few years after menopause and continues into the postmenopausal years. The condition is more likely to develop if you did not reach your optimal bone mass. For those people sustaining fractures after age 50, one out of every two women and one in eight men will have it relate to osteoporosis.

Risk Factors
Certain factors can contribute to an individual’s likelihood of developing osteoporosis. These can be grouped into two categories:

Risk factors you cannot change: such as gender, age, body size, family history, and ethnicity.

Risk factors you can change: abnormal levels of sex hormones, abnormal menstrual cycle, low estrogen levels (menopause), and low testosterone level in men; a diet low in calcium and vitamin D; use of certain medications such as cortisone or anticonvulsants; Inactive lifestyle or extended bedrest; cigarette smoking; excessive use of alcohol, and obesity.

According to “What Your Doctor May Not Tell You About Premenopause,” by Dr. John Lee, as women age estrogen levels decrease and the risk of osteoporosis increases. Women who took birth control pills during their reproductive years may reduce their risk of osteoporosis developing later in life, probably because of the estrogen that many oral contraceptives contain.

Diagnosis
As part of a comprehensive medical assessment, your doctor may recommend that you have your bone mass measured. Bone density is measured in the spine, wrist, and/or hip (the most common sites of fractures due to osteoporosis.) Bone density tests can detect low bone density before a fracture occurs, predict the risk of fracturing in the future, and determine the rate of bone loss and monitor the effects of treatment at yearly intervals.

Treatment
A comprehensive osteoporosis treatment program includes a focus on proper nutrition, exercise, safety to prevent falls that could cause fractures, and medications that slow bone loss and increase bone density.

Calcium and Vitamin D play a significant role in the prevention and treatment of osteoporosis. Common sources of calcium include low fat dairy products, dark green, leafy vegetables, tofu, and foods fortified with calcium, such as orange juice and cereals. The body’s demand for calcium is increased during childhood and adolescence, when the skeleton is growing, and during pregnancy. Postmenopausal women and older men also need to consume more calcium. Vitamin D plays an important role in calcium absorption and in bone health. It is synthesized in the skin through exposure to sunlight. Vitamin D production decreases in the elderly, in people who are homebound, and during the winter. These individuals may require vitamin D supplementation to ensure a daily intake of up to 800 IU.

Exercise is an important component of a prevention and treatment program. Weight-bearing exercises improve bone density, increase muscle strength, and coordination. While exercise is good for people with osteoporosis, it should not put excessive strain on the bones. Your physician can recommend specific exercises to strengthen and support your spine and extremities.

Estrogen replacement therapy (ERT) in women can reduce bone loss and increase bone density in the spine and hips. ERT is administered most commonly in the form of a pill or skin patch. When estrogen is taken alone, it can increase a woman’s risk of developing cancer of the uterine lining (endometrial cancer). To eliminate this risk, physicians prescribe the hormone, progestin, in combination with Estrogen for those women who have not had a hysterectomy. ERT is recommended for women whose ovaries were removed before age 50. Estrogen replacement should be considered in postmenopausal women who have risk factors as reviewed above.

Medications including estrogen, calcitonin, alendronate, raloxifene, and risedronate are approved by the Food and Drug Administration for the treatment of postmenopausal osteoporosis. Estrogen, alendronate, risedronate, and raloxifene are also approved for the prevention of the disease. Alendronate and risedronate are approved for use by men and women with corticosteroid-induced osteoporosis.

In summary, osteoporosis and fractures can be prevented with proper detection and treatment. Treatment with exercise, hormones, and prescription medications should all be utilized after discussing the benefits and risks with your doctor.

For more information on any of these procedures, please contact our office at 770-421-1420.