Womens Health Blog

What is osteoporosis?

Osteoporosis is defined as a decrease in the bone mass of the body. In other words, the bones become thin. Thinner bones are weak and therefore break easily. This is why various fractures are more common in women after menopause even with minimum injury. Bone loss and weakening is natural with age and occurs in men also. It, however, occurs more rapidly in women after menopause.

Symptoms: Unless there is fracture, osteoporosis normally does not cause any symptoms. Fractures due to osteoporosis are more common in the backbone, wrist, hip, upper part of the hand and pelvis.

Diagnosis: It is easy to diagnose osteoporosis in older women who have a fracture. Normally blood tests to measure the levels of calcium, phosphorus and alkaline phosphatase are recommended to rule out other associated diseases of the bones. In case your doctor suspects some disorders of other organs of the body, he or she is likely to recommend further tests to make an accurate diagnosis.

Bone mass measurement: Several newer techniques are now available that can accurately assess bone mass as compared to a conventional x-ray. These include single and dual photon absorptiometry and CT scanning. Photon is the smallest quantity of electromagnetic energy. It can occur in the form of x-rays, gamma rays or a quantum of light. Single and dual photon absorptiometry is the procedure where the amount of photon received by the bones is measured. The results indicate the density of the bone mass. CT scanning or computed tomography is an x-ray technique that produces films representing detailed cut sections of the bones. It is a painless and non­invasive procedure and therefore requires no special preparation before the test.

Several studies have indicated that measurement of bone mass can assess the future risk of fractures. Depending on the results of bone mass assessment, your doctor will be able to decide whether you require hormone replacement therapy or not to reduce the risk of osteoporosis.

Treatment

After confirming diagnosis of a fracture due to osteoporosis, your doctor will recommend rest, pain-killers and other medicines to relax the muscles. Immobilization of the affected part of the body is avoided as far as possible because lack of movement itself can lead to bone loss.

The pain normally subsides within a few weeks provided no fresh fractures occur. Your doctor is also likely to recommend calcium tablets and estrogen replacement therapy, provided you are below sixty-five years of age and do not have any contraindication for taking estrogen.

Prevention: The best way to reduce the risk of osteoporosis and associated fractures is to prevent bone loss. There are several preventive measures to reduce the risks, and each is believed to have a role. You need to start these preventive measures early, at least just before or during menopause, in order to ensure that they are effective. You can prevent osteoporosis through the following methods:

• Calcium intake: Several studies have persuasively indicated that inadequate calcium intake adversely affects the bones in the body. Calcium absorption from the intestines reduces as age advances. Thus, calcium deficiency gets worse when you do not consume adequate calcium in the diet, which will be more than your earlier requirement.

In order to prevent osteoporosis, you need to consume about eight hundred to fifteen hundred milligrams of calcium per day. Most medical researchers opine that the type of calcium you take - whether in your diet or as supplement- is not important. However, more studies are needed to establish the most effective way to ensure adequate calcium intake by the body. It is desirable that you develop a dietary pattern that includes larger portions of calcium rich foods. Rich sources of calcium commonly available in the Indian diet include cereals such as ragi, milk and milk products, and fruits such as custard apple.

• Exercise: Prolonged periods of immobilization of the body leads to increased bone loss. It is believed that moderate and regular exercises reduce the bone loss in older age groups.
• Estrogen: The most effective way to prevent bone loss in women during and after menopause is to take estrogen. The minimum effective dose of estrogen depends upon the type of estrogen, calcium intake and other associated factors that increase the risk of bone loss. Most women need to continue estrogen therapy for about five to ten years. As mentioned earlier, estrogen therapy can cause several side effects. Your doctor will therefore first assess the risk of osteoporosis and then recommend estrogen, if necessary.

Non-hormonal medicines for osteoporosis: Sometimes medicines other than estrogen are recom­mended for management of osteoporosis. These medicines act just like estrogen. They prevent thinning of the bones and prevent calcium for being pulled out of the bones. Commonly used non­hormonal medicines for osteop­orosis include:

• Calcitonin: This is a synthetic medicine that is normally recommended about five years after menopause. It is effective for women who have already developed osteoporosis and for whom estrogen is contraindicated.
• Selective estrogen receptor modulators: This medicine is recommended for women who do not have hot flushes but are at risk of developing osteoporosis. It is not recommended if you have hot flushes as they can worsen them. It is also not recommended if you are at risk of developing blood clots in the veins or have liver disease.
• Blophosphonates: This medicine reduces the activities of cells that induce bone loss. Blophosp­honates have several side-effects and are therefore not routinely recommended.

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