Osteoporosis In Women Dr. Havya Polarapur June 6, 2022

Osteoporosis In Women

Osteoporosis is a disease of the bones and a major age-related health concern. Our inactive lifestyle fosters the likelihood of this condition further. It is irreversible and increases the risk of fractures. Osteoporosis is not by itself painful but the fractures it can lead to are what makes the condition debilitating. 

Let’s dive to learn more deeply about this! 

So, What is Osteoporosis?

Osteoporosis refers to ‘porous bones’. Think of bones as a sieve. A sieve with small, distributed holes will work well. A sieve with very large holes makes it unfit for use.  

Our bones have small holes but due to osteoporosis, as we grow old, these holes enlarge. Osteoporosis renders bones fragile and thinner, making you highly susceptible to fractures. These fractures can happen anywhere in the body but back and hip fractures are more common.  

Our bones decay and regenerate all the time. The breaking down of old bone cells is called bone resorption. This process is followed by the formation of new bone cells. As we age, bone growth reaches its peak, and the rate of resorption increases, but the process of new bone formation gets slower. When there is a mismatch between the resorption rate and the formation of new bone cells, it can lead to osteopenia or osteoporosis.  

Who is likely to get osteoporosis?

Osteoporosis can happen to anyone. It is one of the most widely prevalent age-related diseases. Scientific studies have found that women are four times more likely than men to get osteoporosis.

As we know, there are always some factors that put you at high risk of osteoporosis. Let’s see some of them below,   

  • Being a post-menopausal woman: The hormone estrogen plays a major role in bone health. After the age of 30 and near menopause, women lose more bone mass. Post-menopause, estrogen levels take a dip and bone loss accelerates. Women who experience early menopause are at a higher risk of developing osteoporosis.  
  • Having a hysterectomy (womb removal). 
  • Female athlete triad: Missed periods, low energy, and low bone mineral density can increase the risk of osteoporosis. 
  • Having an eating disorder such as anorexia or bulimia can increase the risk due to acute nutrient deficiency. 
  • Thyroid problems: An overactive thyroid gland, or medication for an underactive thyroid gland. 
  • Having a family history of osteoporosis. 
  • Long term use of steroids. Medication for seizures or cancer can impede the bone rebuilding process. 
  • Being of white or Asian descent increases the risk of osteoporosis. 
  • Having osteopenia: is also generally regarded as the first stage of Osteoporosis. Osteopenia refers to low bone density. 
  • Having a smaller body frame may be an indication of lesser bone mass, accelerating the risk for osteoporosis. 
  • Smoking and alcohol consumption. 
  • Long periods of bed rest, immobility, or an inactive lifestyle. 
  • Low levels of calcium.  
  • Having auto-immune disorders such as rheumatoid arthritis or Lupus. 
  • Undergoing a gastrointestinal surgery that could meddle with calcium absorption in the stomach. 

Take a breath and read on, because you don’t want to miss out on the marrow (pardon the pun) of the matter. 

Symptoms of Osteoporosis: 

Osteoporosis is considered one of the silent diseases that quietly creeps in.

Most of the time the diagnosis happens only after a fracture has been incurred or bones have weakened. Some signs include: 

  • Loss of height
  • Stooped posture
  • Back pain
  • Frequent fractures
  • Straining to get up or move about 

But before you freak out that this might be you in the future, we have good news!  

Osteoporosis is highly preventable. 

Yes, being at risk of osteoporosis or even having osteopenia does not necessarily mean that you will develop osteoporosis. 

As they say, the best time to plant a tree was ten years ago, the next best is now. Similarly, for this ailment to be prevented, actions must start early

Here are a few things you can do to prevent osteoporosis: 

  • Calcium: Calcium intake is imperative to healthy bones. Milk is one of the best sources of calcium. But yes, you are an adult and may be lactose intolerant, or simply not like milk, what then? We got you covered! Besides dairy products calcium can be consumed through broccoli, dried figs, chia seeds, fish, and calcium-enriched juices. Calcium supplements can also be used after consultation with a doctor. 
  • Vitamin D: Devil works hard, but vitamin D works harder. Vitamin D is important for bone health because it helps absorb the calcium you consume. Basking in the sun, as we know it, is the best free source of vitamin D. Red meat, liver, and egg yolks are some good sources of vitamin D. Milk or breakfast cereal fortified with vitamin D may also be a good choice. This vitamin not only helps keep your bones healthy but improves mood too —talk about a better deal!  
  • Active lifestyle: Studies have emphasized the importance of exercise or healthy bones and the prevention of osteoporosis. 

Weight-bearing exercises such as walking, running, and jogging help with strengthening bones. Pair this with resistance training for best results. This may be your sign to take a small walk! 

Diagnosis for Osteoporosis:   

Diagnosis can be tricky as most women before menopause may not be recommended a Bone Mineral Density (BMD) test, as their likelihood of incurring a fracture is low. After a thorough examination of physical health and risk factors, a woman will be prescribed further evaluation by their healthcare provider.   

BMD test is evaluated using Dual-energy X-ray absorptiometry (DEXA).   

Also, when there is osteoporosis on the knee (or hips) a knee replacement surgery will be advised by an orthopedic surgeon based on the level of bone degradation. 

Treatment for Osteoporosis:  

 Treatment for osteoporosis varies for every individual depending on the risk of fractures.  

  • In case of a low risk of fractures, lifestyle changes recommended by your healthcare provider must be incorporated. Quitting smoking, and alcohol, consuming calcium and vitamin D supplements, and exercising are some of the requisite lifestyle changes to treat women with low-risk osteoporosis. 
  •  For individuals with medium-risk of fractures, lifestyle changes are recommended. Medicines may or may not be prescribed depending on other factors. 
  •  Those with a high risk for fractures and increased bone loss, medication or hormone therapies are necessary. 

Now comes that part where we learn about medication and be better informed! But remember, these medications can only be taken if prescribed by a medical professional under careful supervision. 

Medication used for the treatment of Osteoporosis: 

  • Bisphosphonates: These drugs are used to treat osteoporosis, myeloma, bone metastasis, and other bone-related conditions. Bisphosphonates are available as generic drugs. They help in treating osteoporosis by preventing the bone resorption process of osteoclasts. They encourage cell suicide (cell apoptosis ) and thereby slow down bone loss.
    Side effects include upset stomach, acid reflux, and potential kidney damage. In rare cases, Bisphosphonates can cause osteonecrosis of the jaw or (damage to the jaw bone). Another serious side effect is a fracture of the thigh bone. These risks increase with the prolonged use of bisphosphonates. 
  • Denosumab is similar to bisphosphonates but gives better results in slowing down bone loss. These are given as injections once every six months.
    Akin to bisphosphonates, they can also have serious side effects on thighs and jaws, or cause an adverse infection upon long-term usage. 
  • Osteo Anabolics are medications, besides preventing bone loss, promote new bone growth. These are only prescribed if other treatments fail to work. Two approved anabolics are Teriparatide and Abaloparatide. Romosozumab is a new anabolic still under study.  
  • Hormone and hormone-related therapy: The sex hormone Estrogen enables bone rebuilding. However, estrogen production declines after menopause. Beginning estrogen therapy early after menopause can reduce the chances of osteoporosis, but it comes with risks attached. It may increase the chances of breast cancer and blood clots.  

Selective estrogen receptor modulators (SERMs) act as both good cop and bad cop. In some places SERMs mimic estrogen and in others they block estrogen. Like estrogen, SERMs increase the risk of breast cancer and blood clots. Other side effects of SERM drugs include hot flashes, leg cramps, and more.    

Living with osteoporosis can be challenging. Besides lifestyle changes and medication, make your surroundings safer to prevent falls and associated fractures. Some medications for osteoporosis may result in dizziness, ask your doctor about such side effects and everything about your medication during consultation.  

And if you don’t already have osteoporosis, incorporating the suggested lifestyle changes will not just help prevent osteoporosis but also improve the overall quality of your life.  

It’s never too late to choose your health and wellbeing.  

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