Osteoporosis literally means porous bone. It is the most common and potentially the most debilitating bone disorder in the world. This disorder is characterized by loss of bone mass, which causes us to have bones of reduced density and strength. These thinner, more brittle bones greatly increase our risk of fractures. To some degree, the nature of bone itself makes it vulnerable to this disease. Bone is growing, living tissue. The loss of bone mass can occur during the body’s natural lifelong process of bone remodeling. It works this way: There are voracious Pac-Man-like critters in your body called osteoclasts. These are programmed to gobble up‚ and get rid of old bone tissue in a process called resorption. There are also worker-critters, called osteoblasts, whose job it is to busily build new bone tissue to replace the old. In nature’s tug-of-war, it is important that the work of the gobblers and of the builders stays in balance, so that bone is remodeled (or renewed), but is not lost. Unfortunately, as we age this is not always possible. Usually up to age eighteen, the builder-workers are ahead and our bones grow. Then, at around age thirty-five, the balance changes and most people begin to lose bone, at the rate of about 1 percent per year. Around menopause, when estrogen levels begin to drop, women lose bone at an accelerated rate, as much as 3 percent of their total bone density in each of the first five years after menopause (and about 1 percent per year after that).
What are the risk factors associated with postmenopausal osteoporosis?
The National Osteoporosis Foundation has identified the following risk factors that may contribute to the development of osteoporosis: a family history of osteoporosis; an early menopause (either natural, usually meaning be- fore age forty-five, or surgical, due to removal of the ovaries); being Caucasian or Asian; a sedentary life-style; and a chronically low dietary calcium intake. Other risk factors that have been implicated are thinness in women, heavy use of alcohol or caffeine, and smoking.
What can I do to prevent osteoporosis? Learn your family history. If this cannot be supplied by members of your immediate family, try to find someone else, such as an aunt who might fill you in on how the women in your family age. Start adopting healthy lifestyle habits now. If we begin early in our lives, we can greatly minimize our risks. Make sure you’re doing your share of weight-bearing exercises, that you’re getting enough calcium, and that you limit your alcohol consumption, because alcohol can lessen your bones’ ability to hold onto their calcium. Quit smoking! Smoking can bring on an earlier menopause, reducing your estrogen production sooner. Discuss osteoporosis prevention with your physician. Learn whether you are a candidate for ERT. In October 1991, the Food and Drug Administration approved the transdermal skin patch for use in the prevention of postmenopausal osteoporosis. The approval of the patch was based on a two-year research study conducted at the Mayo Clinic in Rochester, Minnesota, which demonstrated the patch’s long-term benefits in preventing postmenopausal bone loss that can lead to fractures. An estrogen pill, Premarin, is also approved for the prevention of postmenopausal osteoporosis.
How IS POSTMENOPAUSAL OSTEOPOROSIS USUALLY DIAGNOSED?
Your physician will probably want to know your complete medical history and your family’s medical history. That information, plus a thorough physical examination and radiological testing of your bone density, if indicated, should provide the foundation of a good diagnosis. However, if fractures have already occurred because of brittle porous bones, the disorder is already under way and the diagnosis is pretty clear. See your doctor!