Osteoporosis

An Important Health Concern for Women
     Women are four times as likely as men to develop osteoporosis, a debilitating condition in which the bones gradually become porous, weak and brittle, making them very susceptible to breaking. Some 1.5 million osteoporosis-related fractures occur in the U.S. every year.

The Brittle Bone Disease
     Decades ago, some women were portrayed with the stereotyped "widow's hump" which was actually a deformity caused by tiny fractures in the spine - the result of osteoporosis. Since then, medical experts have learned a great deal about this painful disease that can affect the hips, spine and wrist. If left untreated, osteoporosis can be debilitating, and may make it impossible to remain active or to walk unassisted.
     Osteoporosis does not happen overnight. It is a progressive disease. Healthy bone continually produces new bone tissue on a daily basis. But as people age, their bones are less able to follow the normal, healthy cycle of growth. Research shows that beginning at age 50, both men and women begin to lose from one to three percent of their bone density every year. When women go through menopause (the cessation of the menstrual cycle), this loss of bone can escalate.

Who Is At Risk For Osteoporosis?
     Most medical experts agree that as women experience a drop in estrogen at menopause, they become very susceptible to bone loss and osteoporosis. National statistics show that about 25% of women over the age of 60 have osteoporosis. In addition, women who experience menopause at an earlier age than most, and women who have their ovaries surgically removed at a young age, are at even greater risk.
      Here are additional risk factors for osteoporosis:

• Small body frame (bones that are normally less dense)
• Northern European or Asian nationality
• Family history
• Diet low in calcium
• The use of steroid medications, such as Prednisone for asthma
• Certain diseases, such as liver disease and hyperthyroidism
• Cigarette smoking
• Heavy consumption of alcohol
• Lack of exercise OR extremely strenuous exercise that stops the menstrual cycle

How Is Osteoporosis Diagnosed?
     A special type of X-ray, the dual energy X-ray absortiometry or DEXA scan, is the best method of measuring the mineral content of the bone. The greater the mineral content, the stronger the bone. The scan is completely painless and is usually performed on the spine, hip and wrist. Some insurance companies cover the test.
      In addition to evaluating a women's risk for osteoporosis, the DEXA scan is useful in determining whether new medications on the market are effective in preventing the disease from progressing.

Can Osteoporosis Be Prevented Or Treated?
1. Diet
      While some risk factors for osteoporosis can't be changed, there are many steps to take for prevention. Eat a well-balanced, healthy diet that is rich in Vitamin D and calcium. Both are essential for building strong, healthy bones.
     The average American women's diet should contain between 1,000-1,500 mg. of calcium and 400 mg. of Vitamin D daily. Vitamin D is found in sunlight, milk fortified with Vitamin D and in certain foods, such as leafy vegetables.
     Calcium supplements are available over-the-counter, but a diet with plenty of calcium is the best source of this mineral. Here are some suggestions:

• 1 cup of plain, non-fat yogurt has 452 mg of calcium
• 1 cup of skim milk has 302 mg of calcium; 2% milk has 297 mg
• 1 oz. of part skim mozzarella cheese has 183 mg. of calcium
• 1/2 cup of fresh, cooked broccoli has 89 mg. of calcium
• 1/2 cup of cottage cheese as 77 mg. of calcium

2. Exercise
     Weight -bearing exercise can help keep bones strong and healthy. Weight-bearing exercise includes brisk walking, running, aerobics, weight lifting, tennis and racquetball; dancing, bicycling, rollerblading, and stair climbing. While swimming is excellent for your overall health, it is not considered a weight-bearing exercise.

3. A Healthy Lifestyle
     Most people are aware that cigarette smoking is damaging to the heart and lungs, but they may not realize that it is also harmful to the bones. Heavy alcohol consumption is also harmful. Kick the habit and learn to lead a healthier lifestyle.

4. Hormone Replacement Therapy
     The best method of regaining bone loss and preventing osteoporosis is to replace hormones lost after menopause. Estrogen (and often progestin, another female hormone) can be re-introduced to the body through a daily oral medication or with a patch. In addition to preventing osteoporosis, hormone replacement therapy can help reduce the risk of heart disease and stroke, and improve memory and concentration.
     Not every woman is a candidate for hormone replacement therapy however, since there is some increased risk for cancer of the breast and uterus. However, each patient is evaluated individually by the physician to determine the benefits and risks.

5. Evista
     Evista, a SERM or Selective Estrogen Receptor Modulator, is aimed at prevention of osteoporosis in place of hormone replacement therapy, and one benefit is that it doesn't affect the estrogen receptors in the breast. Preliminary research suggests that it may reduce the risk of breast cancer.

6. New Medications
Fosamax ™
     Women who already have oteoporosis may benefit from a new class of drugs called Bisphospohonates. Fosamax ™ is the only FDA-approved Bisphosphonate for treatment of osteoporosis. Like estrogen, Fosamax ™ increases bone mineral density and reduces bone loss. Daily use for three years has been shown to make the spine and hips stronger and to reduce the risk of fractures.
     Because Fosamax ™ is not a hormone, it will not increase the risk for breast or uterine cancer. Yet, unlike estrogen, Fosamax ™ does not have the additional benefit of preventing menopause-related symptoms, such as hot flashes, night sweats and vaginal dryness, or the medical advantage of preventing heart attack and stroke.
     For people who develop osteoporosis from taking steroid medications or for men with osteoporosis, Fosamax ™ may be very beneficial. Research is still ongoing.

Calcitonin
     Calcitonin is a hormone that can be prescribed for treatment of osteoporosis when estrogen therapy or Fosamax ™ can not be given. Calcitonin is effective at preventing bone loss, but does not strengthen the hip, and it has not been shown to prevent bone fractures. It can be given by injection or through nasal inhalation. Potential side effects include nausea and skin rash.

    While osteoporosis is certainly a major health concern for women today, there are many steps that can be taken to reduce the risk of developing this disease. Eat a healthy, well-balanced diet with foods rich in calcium and Vitamin D, exercise on a regular basis and maintain an adequate level of estrogen in the body to keep bones strong and healthy for a lifetime.