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Osteoporosis |
Mid-life is a critical turning point for a woman’s bones. We lose bone most rapidly at a rate of 2% to 4% annually during the three to ten years immediately following our last period. By age 60, many women can lose up to 25% of their bone mass. After that age, the loss slows, but we are still losing bone faster than it can be replaced. As a result, bones become thinner, weaker, and more fragile. When too much bone is lost, we can develop osteoporosis, a disease that puts us at risk for fractures. The incidence
Osteoporosis literally means “porous bones.” It is a debilitating disease that is a serious health threat to 44 million Americans, 80% of whom are women. 10 million individuals already have the disease, and 34 million more have low bone mass, putting them at an increased risk for osteoporosis. Each year, this disease causes over 1 million fractures of the spine, hip, wrist and other bones. 40% of women over 50 will experience an osteoporosis related fracture in their lifetime.
The effects
In the early stages, osteoporosis may have few, if any, noticeable signs. As the disease progresses, fractures can occur. These fractures can result in chronic pain, a curved back or “dowager’s hump,” loss of height and restricted mobility. In fact, fractures can occur from simple daily activities like carrying a bag of groceries, lifting a grandchild or even a minor injury.
Who is at risk?
All post menopausal women are vulnerable to osteoporosis, but several risk factors can increase our chances of developing the disease.
How strong are your bones?
Routine X-ray of bone cannot detect osteoporosis until loss of bone mass exceeds 30%. However, there is a test called a Bone Mineral Density Test(BMD) that provides a measurement of “bone density”. The fastest and most accurate test is the dual energy X-ray Absorptiometry (DXA). During the test, you lie on a table, and an X-ray machine takes a picture of your skeleton. The test uses very low amounts of radiation and takes no more than 20 minutes. You don’t need to undress. The test requires no special preparation. If you have the test, it is best to wear comfortable clothing, preferably without metal buttons or zippers.
Ask your doctor if a bone mineral density test is right for you.
Can I prevent osteoporosis?
At every age, our bodies need calcium to keep bones strong. The preferred source of calcium is food. Good sources of calcium include milk, cheese, yogurt, ice cream, canned salmon and sardines with bones, tofu, almonds, calcium fortified foods and juices, spinach, broccoli, turnips, kale, beans, and soybeans. Most American women have a calcium deficient diet, making a change in diet or calcium supplements advisable. Calcium citrate and calcium carbonate are absorbed most readily by our bodies. Daily recommended amount of calcium is 1200-1500 mg.
Our bodies also need Vitamin D to help absorb calcium. Good sources of Vitamin D include milk (fortified in the U.S. with Vitamin D), egg yolks, saltwater fish, liver and sunshine (about 15 minutes daily during summer months). Daily recommended amount of Vitamin D is 800 IU.
Like muscle, bone responds to exercise by becoming stronger. Inactivity makes bones become more fragile, increasing the risk of fracture. 30 to 60 minutes of weight bearing exercise 3 times a week can help maintain bone. Weight bearing means forcing our bones and muscles to work against gravity. Examples include walking, jogging, playing tennis, golfing, dancing, climbing steps, taking aerobic classes, yoga, pilates, gardening and lifting weights.
Treatments
In spite of lifestyle of plenty of calcium, vitamin D, and exercise, some women still experience a significant bone loss and need a medical treatment to prevent further thinning of the bones.
We have several options.
Estrogen replacement therapy has been proven to reduce bone loss. It is especially effective if taken immediately after the menopause when women experience the most significant bone loss as well as suffering other menopausal symptoms. However, recent reports have indicated that estrogen replacement therapy may be associated with certain potential health risks.
Bisphosphonates, best known as Fosamax, Actonel, and Boniva, reduce absorption of the bone while allowing bone formation. They can be taken either weekly, monthly, or quarterly. The main contraindication is gastroesophageal reflux disease (chronic heartburn). One potential side effect, although quite rare, is osteonecrosis of the jaw (death of segment of jaw bone from lack of blood supply).
Selective estrogen receptor modulators, like Evista, are compounds which have estrogen like effects on some parts of the body. Evista is FDA approved for both the treatment and prevention of post menopausal osteoporosis. Some women are unable to take it due to severe hot flashes.
Calcitonins, like Miacalcin, are delivered by nasal spray or injection. It is FDA approved for the treatment of postmenopausal osteoporosis.
You and your physician can determine the best treatment for you, after reviewing your medical history as well as family history.
At Paul Larson Ob-Gyn Clinic, we offer Hologic DXA bone density testing and can perform lab testing to rule out causes of osteoporosis. |
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