Osteoporosis

Osteoporosis is a bone disease in which the strength and density of your bones decreases, thereby increasing the chance of a fracture. Bone is a living tissue and contains living cells. Throughout life, our bones are constantly being renewed where old bone is removed and replaced with new bone. As people get older, the body’s ability to replace old bone with new bone goes down, and bones may become less dense. With osteoporosis, there is too little bone formed, too much bone lost, or both – which may lead to bone weakness or higher risk of fractures. It’s also important to remember that the overall health and strength of your bones can be impacted by many things like genetics, environment, gender, hormones, nutrition, and physical activity.

In general, osteoporosis arises with conditions that either decrease your ability to build bone or increase bone loss. Aging is a key risk factor for osteoporosis. Women are much more likely than man to develop osteoporosis because – in general - their bones are smaller, thinner, and less dense, and they tend to live longer. Also, menopause is a risk factor for osteoporosis because women tend to lose more bone after menopause due to lower levels of estrogen. In fact, it is estimated to impact over 200 million women worldwide.

Other risk factors associated for osteoporosis include:

• Race: Caucasians are at higher risk of having osteoporosis.
• Genetics: Those with a family history of osteoporosis are at higher risk of also having this disease.
• Body size: People with thin, slight frames are more likely to have osteoporosis.
• Medical conditions: Certain medical conditions –an overactive thyroid gland or other hormone problems, for example – can increase the risk of osteoporosis.
• Medications: Certain medications –steroids, in particular – are associated with increased bone loss and osteoporosis.
• Lifestyle factors and diet: There are many lifestyle factors that are considered osteoporosis risk factors. Smoking, too much alcohol, poor diet, and lack of physical activity can increase risk for osteoporosis.

Osteoporosis is considered a “silent” disease, and most people don’t learn they have it until they find themselves with broken bones. In fact, frequent bone fractures are a good indication of osteoporosis, especially if someone has a fracture without a fall or a trauma. Osteoporosis often impacts the spine, but also bones in the wrist, upper arm, or thigh.

Other symptoms may be noticeable. For example, osteoporosis may result in sloping shoulders, curves in the back, loss of height, hunched posture, or back pain.

A doctor can order a radiology test – called a bone mineral density test - to measure the strength of your bones and help make a diagnosis of osteoporosis. Testing is done in different areas of the body, usually the hips, spine, and forearm, to determine where bone loss is present. A doctor will decide if you need the test based on your age, risk factors for osteoporosis, or other clinical factors. The doctor may also order other tests such as a bloodwork to see if other medical conditions may be impacting your bone health.

For patients at risk for osteoporosis or with a diagnosis of osteoporosis, there are many options that a patient can consider with her doctor. In general, recommendations to patients revolve around actions to help to prevent loss of bone or help build new bone. For example, exercise is important for building and maintaining bone strength. Your doctor may advise weight-bearing exercises, such as walking or running, that require your body to work against gravity.

Women should speak with their doctor about the best options for them and their clinical menopause journey.