As women grow older, it is important to be aware of the dangers of osteoporosis, a condition that affects primarily post-menopausal females. The word osteoporosis comes from “osteo” (bone) and “porosis” (porous). Osteoporosis is a reduction in the strength and durability of bones. Over time, the patient’s bones become more brittle and less able to heal after fractures, for which risk is greatly increased to to loss of flexibility in bone tissue.
The substances that keep bones strong are protein, collagen and calcium. Over time, osteoporotic bones lose these vital building blocks, and the risk of fracture increases. Fractures can be in the form of a cracked bone, as happens with hip fractures, or collapsing bone, as happens in the spine. These two areas are the most common site of broken and collapsing bones, although other bones may also be affected.
Initially, patients are usually asymptomatic. After a fracture of the vertebra of the spine, there is pain from the back circling the sides of the body. Repeated spinal fractures over a period of time can lead to chronic back pain, lessening of height and even curving of the spinal column. About one in five women who suffer a vertebral fracture will have a subsequent fracture in the future.
Fractures of the pelvis and hip usually happen during a fall. Even minor slip and fall type accidents can result in fractures for people affected by osteoporosis. This can result in considerable pain and a diminished quality of life, as well as the inability to work or participate in the usual activities of daily life.
A hip fracture, if prolonged, can confine the patient to bed and lead to thrombosis in leg veins, which in turn can break off and move up to the lungs, causing pneumonia.
The hormone estrogen is vital to maintaining bone density in women. While estrogen levels are stable, the level of bone remodeling (the removal and addition of bone) continues at a health pace. But when a woman enters menopause, estrogen levels drop and the body is unable to continue to reconstruct bone as needed.
The risk factors for osteoporosis are:
Race: Caucasian or Asian
Build: Thin and small
Cigarette and alcohol use
Lack of physical exercise
Calcium deficient diet
Low estrogen levels
Low testosterone (male sex hormone) levels in men
Hyperparathyroidism: excessive parathyroid hormone (PTH). PTH facilitates the removal of calcium from bones. If PTH is excessive, more calcium is removed and osteoporosis can happen.
Diet low in Vitamin D (which helps absorb calcium from food)
Women entering into menopause and beyond, and men who have any of the risk factors detailed above, should have regular bone density tests, engage in regular weight-bearing exercise, and stay on a diet rich in calcium and vitamin D. Discuss with your doctor the medications now available to halt the progress of osteoporosis. Women should also talk to their doctor about the pros and cons of hormone replacement.