Frequently Asked Questions About Osteoporosis
1. What is osteoporosis?
Osteoporosis is a disease in which bone density and quality are reduced. As bones become more porous and fragile, the risk of fractures greatly increases. Bone loss occurs "silently" and progressively – often there are no symptoms until the first fracture occurs. For these reasons, osteoporosis is often referred to as the "silent epidemic".
2. What are the risk factors for osteoporosis?
The hormonal changes that take place at menopause are one reason why women are at greater risk of osteoporosis than men. Bone tissue loss generally begins after the age of about 40 years, when we are no longer able to replace bone tissue as quickly as we lose it. In women, however, the rate of bone tissue loss increases after menopause, when estrogen production stops and bones no longer benefit from its protective effect.
There are a number of other risk factors associated with osteoporosis:
- A close family member diagnosed with osteoporosis
- A family history of fractures resulting from minor bumps and falls
- Frequent falls
- A previous fracture
- Long-term enforced bed rest
- Little physical activity
- Low body weight
- Loss in height
- Periods stop for more than 12 months
- A diet low in calcium and vitamin D
- High alcohol intake
- Smoking
- Certain medications in long-term use such as corticosteroids
- Age 60+
- Chronic disorders such as anorexia nervosa, malabsorption syndromes including coeliac disease and Crohn's disease, chronic liver disease, primary hyperparathyroidism, post-transplantation, chronic renal failure, hyperthyroidism, Cushing's syndrome, arthritis
3. How common is osteoporosis?
Osteoporosis is one of the most common and debilitating chronic diseases, and a global healthcare problem. Around the world, one in three women and one in five men over the age of 50 will suffer an osteoporotic fracture. Although more common in older people, osteoporosis can also affect younger people.
4. How can I find out if I have osteoporosis?
As osteoporosis has no obvious symptoms other than a fracture when the bone is already significantly weakened, it is important to go to the doctor if any of the risk factors apply to you. The doctor will take a thorough medical history that includes information on any recent fractures and may determine that the next step is to have a bone mineral density (BMD) test. A number of different types of BMD tests are available, but the most accurate is DXA (dual energy X-ray absorptiometry). DXA is a low radiation X-ray capable of detecting quite low percentages of bone loss.
5. How can I prevent weak bones?
Although heredity plays a large part in determining whether you will be at heightened risk of osteoporosis, certain lifestyle factors play a key role in helping to build and maintain strong bones. The best way to help prevent weak bones is by starting with good exercise and healthy eating habits in childhood and maintaining these good habits as an adult. Ensure that you get enough calcium and vitamin D each day, eat a healthy diet, do regular weight-bearing exercises, don't smoke, and only drink alcohol in moderation. Be aware of any personal risk factors that may affect your bone health (such as long-term use of steroids or certain chronic disorders) and consult your doctor if you are at heightened risk. Depending on the results of diagnostic testing, your doctor may prescribe medicines and supplements to prevent bone loss.
6. How can I help my daughter have strong bones?
Help your daughter to get enough calcium and vitamin D, so that she is building strong bones while she is young. Encourage your daughter to have a balanced diet with sources of calcium and protein. Milk and other dairy foods are among the richest and most readily available sources of calcium in the diet. Educate her about the importance of weight-bearing exercises and the effects of smoking and excessive alcohol on bones. It is also important that she understands that having a healthy body weight (no crash diets!) will help her to build strong bones. Tell your daughter that beauty is bone deep - no one should be obsessed with thinness at the expense of bone health.
7. What are the treatments for osteoporosis?
There are a number of effective treatment options that have been shown to act quickly (within one year), to maintain bone density and to reduce the risk of having fractures. It is important that the choice of treatment be tailored to a patient's specific medical needs and lifestyle. Common treatments that are currently available (although not in all countries) are: bisphosphonates (alendronate, ibandronate, risedronate), calcitonin, raloxifene, strontium ranelate, teriparatide and tibolone.
Hormone replacement therapy (HRT), although not specifically for the treatment of osteoporosis, has also been shown to have a beneficial effect on bone.
Calcium and vitamin D supplements are also usually prescribed, to ensure adequate intake, and to ensure maximum effectiveness of the drug therapy. Sufficient calcium, vitamin D and protein intake not only helps to prevent osteoporosis, it is also important in helping to maintain bone density and muscle function in patients diagnosed with osteoporosis.
