If you’re a postmenopausal woman, osteoporosis is the major cause of fractured bones, which happen most often in the hip, vertebrae and wrist.
“Estrogen is necessary for bone health,” said Ginny Czimber, a family nurse practitioner at Novant Health Endocrinology - Shallotte. “When you reach menopause, and you're no longer making any estrogen or very little, your bone density suddenly starts to decline. Osteoporosis is much more common in women than it is in men.”
Osteoporosis is a disease in which your bone density decreases, which can lead to loss of bone strength and increase your risk of fractures. It can happen to anyone – in any bone – but your risk increases as you age.
Approximately 10 million Americans have osteoporosis and another 44 million have low bone-density, known as osteopenia, placing them at increased risk.
Symptoms of osteoporosis
“There are no signs or symptoms of osteoporosis,” Czimber said. “The only way you know what's happening is if you get a bone density study.”
She recommends the test at age 65 for women and 70 for men, if you don’t have significant risk factors, such as smoking, taking large doses of steroid medications, heavy drinking, or haven’t broken a bone with a non-traumatic injury. If you have any of those issues, discuss with your physician about getting the test at an earlier age.
Bones affected by osteoporosis can become fragile enough that fractures occur spontaneously or by minor falls or normal stresses such as bending, lifting or even coughing.
Osteoporosis risk factors
Some risk factors you can’t change, such as gender (women are at higher risk) and age (as you get older, bone loss happens more quickly). Others include:
- Body size: Slender, thin-boned people are at greater risk to develop osteoporosis because they have less bone compared to larger-boned people.
- Race: White women and Asian women are at highest risk. Black women and Mexican-American women have a lower risk. White men are higher risk than Black and Mexican-American men.
- Family history: Your risk of osteoporosis is higher if one of your parents has a history of the disease, or has broken a hip.
- Other medical conditions can increase your risk, including endocrine and hormonal diseases, gastrointestinal diseases, rheumatoid arthritis, cancer, HIV, AIDS and anorexia nervosa.
What you can do to reduce your risk
- Include calcium and vitamin D in your diet: If you don’t take in enough calcium, your body takes it from your bones, which could lead to bone loss. Good sources of calcium are low-fat dairy products; dark green leafy vegetables, such as spinach, bok choy, collards and turnip greens; sardines and salmon, broccoli, and calcium-fortified foods such as soymilk, tofu, orange juice and cereals.
“All the milks have the same amount of calcium in them, so low-fat or skim milk is probably the best option health-wise,” Czimber said.
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Foods that contain a lot of vitamin D include fatty fish (salmon, tuna, sardines, mackerel and trout), fish oils, egg yolks and liver. Another easy way to receive vitamin D is through sunlight.
“The problem is, we're also skin-cancer-conscious,” Czimber said. “We're putting sunblock on and that blocks the ultraviolet rays, but also some of the vitamin D from getting absorbed.”
Czimber said that when you reach age 45, have your primary care provider check your vitamin D level every so often to make sure it’s sufficient.
- Exercise: “You want to do some resistance or weight-bearing exercises,” Czimber said. “Walking is good for your bones. Using hand weights or bands to exercise, or walking in a pool are good bone-building exercises. You don't have to be in great physical shape to preserve bone, but you have to actually move.”
- Do not smoke: Tobacco usage increases your rate of bone loss.
- Limit alcohol: Too much alcohol can decrease bone formation. Women shouldn’t have more than one drink per day, and men no more than two drinks daily. Excessive drinking also increases the risk of falling.
- Prevent falls: Remove electrical cords, area rugs and slippery surfaces in your home. Keep rooms brightly lit, install grab bars inside and outside the shower door, and make sure you can get into and out of bed easily.
Treatment for osteoporosis
Czimber said there are several options, and most patients start with bisphosphonate therapy, an oral medication that helps slow bone loss and lower the chance of fracture. Alendronate and Actonel are two common oral medications, and are taken weekly or monthly, she said. Reclast is an annual infusion of bisphosphonate medication. Patients also can choose Prolia, which is given as a twice-a-year injection.