Causes of Osteoporosis
As the body makes new bone, the old bone is broken down. The new growth increases bone mass and improves bone strength. Bone mass typically peaks during the early 20s. As we age, bone mass loss begins to exceed growth.
Bone density starts to decrease in the mid 30s, and women are five times more likely to have osteoporosis than men. Post-menopausal women experience more rapid bone loss. Weak bones are more prone to fracture.
There are a number of risk factors for osteoporosis, including:
- Calcium deficiency
- Certain medications including long-term steroids and antacids containing aluminum
- Too much vitamin A
- High salt intake
- Lack of vitamin D
- Anorexia or other eating disorders
- Gastrointestinal bypass surgery
- Excess alcohol intake (3 or more drinks/day)
- Not enough exercise
- Hormonal conditions such as thyroid disease and low sex hormones
Signs & Symptoms of Osteoporosis
Many women are not even aware they have osteoporosis, since symptoms don’t develop right away. As the condition progresses, spinal bones can break or collapse causing the spine to curve. Posture becomes stooped and individuals with osteoporosis may experience a loss of height. Back pain may also develop.
If osteoporosis is severe, even minor falls can result in broken bones.
All women over age 65 should have a bone mineral density test (BMD). Your OBGYN may recommend a BMD if you are a post- menopausal woman who has experienced a bone fracture due to fragile bones, you have rheumatoid arthritis, are a smoker, have a history of heavy alcohol use, have a parent who has broken a hip due to osteoporosis or if you weigh less than 127 pounds.
Bone density is measured at the heel, spine, hip, hand or wrist through using low level x-ray. The test is painless.
Women with normal BMD test results are advised to have the test every 5 years. If you have been diagnosed with osteoarthritis, your gynecologist may recommend the test be done more often.
FRAX is a computer program that is used to estimate fracture risk. Using your age, sex, body mass index, smoking history, alcohol intake and additional risk factors, FRAX can help determine your risk of fracture and whether or not treatment is indicated.
Osteoporosis Treatment Options
Those at a higher risk of fracture may be prescribed a bisphosphonate medication such as Fosamax or Actonel. These medications also come in IV or injectable forms for those who don’t tolerate them in oral form.
Estrogen given after menopause can also help in maintaining bone density, but it may not be suitable for women with a history of blood clots, certain types of cancer and/or heart disease.
Other medications may also be used to stimulate new bone growth or improve bone density.
Lifestyle choices that can reduce the risk of developing osteoporosis, or help with balance and posture, include: regular exercise such as walking, Tai Chi, Yoga, Pilates and strength training.
Diet plays an important role in osteoporosis prevention, too. Calcium-rich foods such as spinach, kale, yogurt, milk, cheese, salmon and sardines protect bone health. If dietary efforts fall short, talk with your gynecologist about whether or not calcium and vitamin D supplements would be beneficial.