Osteoporosis, which means "porous bones," is a condition of excessive
skeletal fragility resulting in weakened bones that break easily. A combination of
genetic, dietary, hormonal, age-related, and lifestyle factors all contribute to this
condition. Osteoporosis usually progresses painlessly until a fracture occurs, which is
usually in the hip, spine, or wrist.
Q: Are women more affected by osteoporosis than men?
Overall, approximately eight million American women and 2 million men have
osteoporosis. Women are four times more likely than men to develop osteoporosis because of
the loss of estrogen at menopause. (Estrogen blocks or slows down bone loss.) Over half of
all women over the age of 65 have osteoporosis. Even though osteoporosis is often thought
of as a disease that only affects older people, it can strike at any age.
Osteoporosis leads to 1.5 million fractures, or breaks, per year, mostly in the hip,
spine and wrist, and costs $14 billion annually. One in two women over the age of 50 will
suffer an osteoporosis-related fracture.
Q: What are the risk factors for osteoporosis?
Factors that can increase your chances of developing osteoporosis include:
being female
a small, thin body frame
a family history of osteoporosis
postmenopausal status or advanced age
Caucasian or Asian race
abnormal absence of menstrual periods
anorexia nervosa or bulimia
low testosterone levels in men
diet low in dairy products or other sources of calcium and vitamin D
inactive lifestyle
long-term use of glucocorticoids (medications prescribed for many
diseases, including arthritis, asthma, and lupus) anti-seizure medications; gonadotropin
releasing hormone for treatment of endometriosis; aluminum-containing antacids; certain
cancer treatments; and excessive thyroid hormone
cigarette smoking
excessive use of alcohol and high salt, protein, and caffeine intake.
Q: What is pregnancy-associated osteoporosis?
Pregnancy-associated osteoporosis is believed to be a rare condition that is usually
found in the third trimester or postpartum period. It usually occurs during the first
pregnancy, is temporary, and does not recur. Women affected usually complain of back pain,
have a loss of height, and have vertebral fractures. In 1996, there had been 80 cases
reported in the medical literature. Researchers do not know if this condition occurs as a
result of pregnancy or because of pre-existing conditions in a pregnant woman. Factors
that may cause this condition, such as genetic factors or steroid use, are being studied.
Even though there is stress on a pregnant womans calcium supply and calcium
excretion is increased by frequent urination, other changes during pregnancy, like
increases in estrogen and weight gain, may actually help bone density.
There is much more to be learned about how a womans bone density is affected by
pregnancy.
Q: Will I suffer bone loss during breastfeeding?
Although significant amounts of bone mineral can be lost during breastfeeding, this
loss tends to be temporary. Studies consistently have shown that when women have bone loss
during lactation, they recover full bone density within six months after weaning.
Q: How would I know if I might have osteoporosis?
A family medical history and bone mass measurements are part of a complete assessment.
Often a bone fracture is the first sign of osteoporosis. Ask your doctor to help you
better understand your own risk and become aware of prevention and treatment options.
Routine x-rays can't detect osteoporosis until it's quite advanced, but other
radiological methods can. The Food and Drug Administration (FDA) has approved several
kinds of devices to estimate bone density. Most require far less radiation than a chest
x-ray. Doctors consider a patient's medical history and risk factors in deciding who
should have a bone density test. Readings are compared to a standard for the patient's
age, sex and body size. Different parts of the skeleton may be measured, and low density
at any site is worrisome. Bone density tests are useful for confirming a diagnosis of
osteoporosis if a person has already had a suspicious fracture, or for detecting low bone
density so that preventive steps can be taken.
Q: How can I protect myself from osteoporosis?
Osteoporosis is usually preventable. Females need to take steps to protect the health
of their bones while they are still children, and on through their teenage and young adult
years. Building strong bones at a young age will lessen the effect of the natural bone
loss that begins to occur around age 30.
Eat foods rich in calcim and vitamin D, such as low-fat milk, yogurt, cheese, fish with edible bones like salmon and sardines, and dark green, leafy vegetables, like kale and broccoli. Do weight-bearing exercise, such as walking, jogging, hiking, playing tennis, and stair climbing. Exercise builds bone and muscle strength and helps prevent bone loss and improves coordination to prevent falls. It also helps older people stay
active and mobile. Weight-bearing exercises, done on a regular basis, are best for
preventing osteoporosis. Always check with your doctor before starting an exercise
program. Consider using calcium supplements, but discuss the choice of supplements with
your doctor first. Don't smoke. Limit alcoholic beverages.
Q: What is the optimal calcium intake for women in different stages of their life?
Diet, hormones, drugs, age and genetic factors all influence the amount of calcium
required for optimal skeletal health. Recommendations vary slightly. Based upon the most
recent recommendations from the National Academy of Sciences (1997) on optimal daily
calcium intake, the following amounts are recommended for these different age groups:
Recommended Daily Intake of Calcium for Women
Ages |
Milligrams per day of Calcium |
9 - 18 |
1300 |
19 - 50 |
1000 |
51 and older |
1200** |
Recommended Daily Intake of Calcium for Women
who are Pregnant or Lactating
Ages |
Milligrams per day of Calcium |
Up to 18 years old |
1300 |
19 - 50 |
1000 |
**NOTE: The National Institutes of Health Consensus Conference and The National Osteoporosis Foundation support a higher calcium intake of 1,500 milligrams per day for
postmenopausal women not taking estrogen and adults 65 years or older.
The guidelines are based on calcium received through diet and through calcium
supplements. Calcium intake up to 2,000 mg/day appears to be safe in most people. Getting
enough Vitamin D is important for your body to absorb enough calcium. Most people receive
enough Vitamin D through sunlight. You can also get this vitamin from supplements, as well
as from cereal and milk fortified with Vitamin D. If supplements are necessary, no more
than 800 International Units (IU) mg/day is recommended. The Women's Active Multi contains proper amounts of calcium, magnesium and vitamin D for the midlife woman.
Q: How is osteoporosis treated?
Lifestyle changes and medical treatment are part of a total program to prevent future
fractures. A diet rich in calcium, daily exercise, and drug therapy are treatment options.
Good posture and prevention of falls are important in reducing the chance of being
injured.
Under FDA guidelines, drugs to treat osteoporosis must be shown to preserve or increase
bone mass and maintain bone quality in order to reduce the risk of fractures. The
following drugs are approved by the FDA for the treatment or prevention of osteoporosis:
Alendronate (Fosamax®) This drug belongs to a class of drugs
called biophosphonates and is approved for both prevention and treatment of osteoporosis.
It is used to treat bone loss from the long-term use of osteoporosis-causing medications
and is used for osteoporosis in men. In postmenopausal women, it has shown to be effective
at reducing bone loss, increasing bone density in the spine and hip, and reducing the risk
of spine and hip fractures.
Risedronate (Actonel®) Like Alendronate, this drug also is a
biophosphonate and is approved for both prevention and treatment of osteoporosis, for bone
loss from the long-term use of osteoporosis-causing medications, and for osteoporosis in
men. It has been shown to slow bone loss, increase bone density, and reduce the risk of
spine and non-spine fractures.
Calcitonin (Miacalcin®) - Calcitonin is a naturally occurring hormone
involved in calcium regulation and bone metabolism. Calcitonin can be injected or taken as
a nasal spray. In women who are at least five years beyond menopause, it slows bone loss
and increases spinal bone density. Women report that it also eases pain associated with
bone fractures.
Raloxifene (Evista®) This drug is a selective estrogen receptor
modulator (SERM) that has many estrogen-like properties. It is approved for prevention and
treatment of osteoporosis and can prevent bone loss at the spine, hip, and other areas of
the body. Studies have shown that it can decrease the rate of vertebral fractures by
30-50%.
Soy Isoflavones - New research findings, published in the prestigious Obstetrics and Gynecology journal, suggest that soy protein should be part of your bone health plan which can include HRT, calcium supplementation and weight bearing exercise at your doctor's direction. Read More...
Bio-identical Estrogen, Hormone Therapy (MHRT) or Estrogen Replacement Therapy (ERT), has also been used to prevent bone loss. Recent studies suggest, however, that this might not be a good option for many women. (NOTE: Power Surge does not endorse synthetic HRT)
Other treatments are being studied. They include new biophosphonates and SERMs, Vitamin
D metabolites, parathyroid hormone, and sodium fluoride. A woman and her doctor need to
carefully weigh the risks and benefits of these treatment options.
For More Information ...
You can find out more about osteoporosis by contacting the National Womens Health
Information Center 800-994-WOMAN (9662) or the following organizations:
National Osteoporosis Foundation
Phone: (877) 868-4520
Osteoporosis and Related Bone Diseases National Resource Center
Phone: (800) 624-2663
Food and Drug Administration
Phone: (888) 463-6332
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Phone: (301) 496-8188
National Institute on Aging
Phone: (800) 222-2225
Reference: The National Women's Health Information Center