Throughout
life, your body's skeleton a living, dynamic, tissue is continually
being remodeled as old bone is removed and replaced by new bone.
Your body forms most of its bone mass, becoming heavier and
denser during the teenage years. Women reach their peak bone
density and bone strength around the age of 25 to 30, while
men build bone until about the age 30 to 35.
Afterwards,
particularly the first few years after menopause, the rate
of bone resorption (breakdown) exceeds the rate of new bone
formation, resulting in decreased bone mass and density.
As bone density decreases, there is a thinning and weakening
of the bones to the point that they are more likely to break,
especially bones in the hip, spine, and wrist. This condition
is called osteoporosis, or "porous bones." Osteoporosis acts
silently, so you can lose bone density and strength over many
years but not know you have it until a bone breaks.
Genetics,
diet, hormones, age, and lifestyle all play influence who develops
osteoporosis. Both men and women experience bone loss as they
age; however, men have less risk of getting osteoporosis because
they do not go through menopause, and lose the effect of estrogen
like women.
Estrogens
play a role in maintaining bone density, by slowing bone loss.
About 25 million Americans have osteoporosis--80 percent are
women. White and Asian women are most likely to get osteoporosis,
although African-American and Latin women are also at risk.
If you have a family history of osteoporosis, early menopause,
or small body frame you are also at a higher risk.
| Click
here for Bone Measurements, Common Questions
and Answers, Strategies, and who will get Osteoporosis. |
You
can't do anything about the genes you're dealt. That's why it's
so important to make the most of the things you can control,
like building strong bones when you are younger so you reduce
the risk of fractures when you are older. A diet that is
rich in calcium and vitamin D, regular weight-bearing exercise
and avoiding bone risks-- like smoking, and excessive alcohol
are the best ways to prevent osteoporosis.
| Osteoporosis
is a major threat for 28 million Americans. In the
U.S. today, 10 million individuals already have osteoporosis
and 18 million more have low bone mass, placing them at
increased risk for this disease |
If
you think you might be at risk for osteoporosis, there are tests
that can measure bone strength and the risk of fracture. The
dual energy x-ray absorptiometry (DEXA) uses radiation to determine
bone density. The spine and hip are most commonly measured,
but the heel, wrist or total body may also be measure. The procedure
takes up to 20 minutes, and results in about as much radiation
exposure as a standard X-ray (if the spine or hip is measured)
or less (if the heel or wrist is measured).
Another test the doctor may use is ultrasound which uses sound
waves, so there is no radiation exposure. Measurements are made
in the heel or in the shin. The procedure can be completed quickly,
generally in less than 10 minutes. The ultrasound device was
shown to be as good as x-ray bone density measurements for diagnosing
osteoporosis and predicting fracture risk. You should discuss
with your doctor the best test for you.
Women
with osteoporosis or who are at risk should, with their physician,
discuss medical treatment aimed at stopping bone loss. Doctors
sometimes prescribe estrogen to replace the hormones lost during
menopause and to slow the rate of bone loss. This treatment
is called hormone replacement therapy (HRT), and consists
of estrogen coupled with progestin. HRT can reduce her increased
fracture risk by 50 to 70 percent. HRT also protects against
heart attack, the most common cause of death in women. However,
all the risks of long-term use of HRT are not known.
| Osteoporosis
is responsible for more than 1.5 million fractures
annually, including 300,000 hip fractures, and approximately
700,000 vertebral fractures, 250,000 wrist fractures, and
more than 300,000 fractures at other sites. |
Raloxifene
(Evista TM) can also be used for the prevention
and treatment of osteoporosis in postmenopausal women. Raloxifene
is one of a new class of drugs called selective estrogen
receptor modulators (SERMs) that mimic the effects of estrogen
in some tissues but not others. Raloxifene acts like estrogen
in increasing bone density, but it does not increase your breast
cancer risk.
Calcitonin
is a naturally occurring non-sex hormone that increases bone
density in the spine and can reduce the pain of fractures. It
comes in two forms--injection or nasal sprays. Alendronate
(Fosamax TM), a drug that belongs to a class of agents called
bisphosphonates, and may actually build bone. This drug is a
from of non-hormonal prevention provides an alternative to estrogen
and calcitonin. The decision to use these medicines will depend
on a women's current risk and medical history.
Remarkable
progress has been made in the understanding of the causes, diagnosis,
prevention and treatment of osteoporosis. Every step brings
us closer to eliminating the pain and suffering caused by this
disease. It is so important because women are living longer
perhaps a third of their lives--past menopause. Although some
bone loss is expected as people age, diagnosis and treatment
of osteoporosis need no longer wait until bones break.
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