Are you at risk for osteoporosis?

One of the most important health issues for middle-aged women is the threat of osteoporosis. It is a condition in which bones become thin, fragile, and highly prone to fracture. Numerous studies over the past 10 years have linked estrogen insufficiency to this gradual, yet debilitating disease. In fact, osteoporosis is more closely related to menopause than to a woman's chronological age. 

Bones are not inert. They are made up of healthy, living tissue which continuously performs two processes: breakdown and formation of new bone tissue. The two are closely linked. If breakdown exceeds formation, bone tissue is lost and bones become thin and brittle. Gradually and without discomfort, bone loss leads to a weakened skeleton incapable of supporting normal daily activities.

Risk factors

  • Menopausal women are at the highest risks because they have decreased hormones. We typically think of estrogen, but progesterone and testosterone are important for maintaining bone density as well. Keep in mind that these hormones may not build bone but may stave off bone loss.
  • Certain other physiological stresses can quicken bone loss, such pregnancy, nursing, and immobility.
  • Women who smoke or drink alcohol experience a higher incidence of osteoporosis.
  • White women and Asian women face the greatest risk of osteoporosis.
  • An inactive lifestyle puts women at a higher risk for developing osteoporosis, however women who are very thin from exercising like long distance running may also be at risk.
  • A history of eating disorders increases the risk of osteoporosis.
  • Women whose family history includes osteoporosis have a higher risk of developing bone loss. 
  • Rheumatoid arthritis. • Hyperthyroidism when levels of thyroid hormone are abnormally high.
  • Conditions that affect the absorption of food such as Crohns or coeliac disease.

Some medicines increase your risk:

  • Taking glucocorticoids (‘steroids’) tablets for other medical conditions for over three months.
  • Anti epileptic drugs. 
  • Breast cancer treatments such as aromatase inhibitors.
  • Diuretics.
  • Anticonvulsants.

Other conditions may be associated with osteoporosis such as diabetes and HIV (AIDS). People who have had an organ transplant or who have experienced respiratory diseases may also be at increased risk, as well as people who have undergone gender reassignment especially if hormone therapy is discontinued.

Preventing Osteoporosis

It is hard to replace bone that is lost. Currently available treatments only halt bone loss - they don't rebuild the bone. Beginning a lifelong commitment to exercise and healthy nutrition while you are still young reduces your risk of developing this condition later in life. Remember, you are never too young to think about preventing osteoporosis.

Exercise increases bone mass before menopause and helps to reduce bone loss after menopause. Bone strength increases with regular exercise. To help prevent bone loss, weight-bearing exercise such as walking, low-impact aerobics, or tennis work best.

It is important to have vitamin D levels checked in the blood yearly as it can discover a deficiency that can be corrected through diet and supplementation. Also, going out into the sun for 10-15 minutes will also help you make your own vitamin D through the skin.

A DEXA bone density scan is recommended for women in menopause, as well as those who had a hysterectomy, have a family history of osteoporosis, or with other chronic health concerns. This simple test will tell you whether or not you need medical supplementation or simple nutritional and weight training intervention.

Remember, osteoporosis is a silent process. Building up your reserves of bone before you start to lose it during perimenopause helps bank against future losses.

Sources: National Osteoporosis Society (http://www.nos.org.uk); American Academy of Physical Medicine and Rehabilitation (http://www.aapmr.org); Mayo Clinic (http://www.mayoclinic.org)

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