Osteoporosis

Overview

Osteoporosis, which means porous bones, is a progressive condition in which bones become structurally weak and are more likely to fracture or break. It is sometimes called a “silent” disease, because bone loss often occurs without your knowing it.

Normally, the body forms enough new bone tissue to balance the amount of bone tissue that is broken down and absorbed by the body. This is a process called bone turnover. Throughout the early part of your life, your body keeps a careful balance between the loss of bone and the creation of new bone. Bone mass increases during childhood and early adult life, reaching a maximum by the age of 30 to 35, when it begins to decline gradually.

Menopause, which happens at about age 50, dramatically speeds bone loss for women. Some older men lose bone mass as they age, as well. Osteoporosis evolves when your body can no longer replace bone as fast as it is broken down.

Over time, bones lose their density, or thickness, and some supporting connections are lost. Decreasing bone density allows breaks or fractures to occur more easily, especially when falling from a standing position. Because bones in the hip, spine, and wrist are especially prone to fragility fractures.

One in two women and one in four men over age 50 will have an osteoporosis-related fracture in his or her remaining lifetime. More than 1.5 million fractures occur in the United States each year and these fractures can lead to serious health problems.

Osteopenia is a condition in which bone density is declining, but the loss in bone mass is more moderate than in osteoporosis. If you have been diagnosed with osteopenia, or even osteoporosis, there are actions you can take to prevent further bone loss.

Depending on the level of bone loss, you may need to exercise and take calcium and vitamin D to keep your bones strong. You also may need to take medications. Ask your physician what action is right for you. Physicians agree that post-menopausal women and older men with osteoporosis should be medically treated to prevent fractures.

What Role do Hormones Play in Bone Disease?

As women age, their ovaries stop functioning during menopause. These small organs, which had produced eggs each month, no longer make the hormone estrogen. Estrogen loss may also occur with the surgical removal of the ovaries or because of excessive dieting and exercise. Estrogen, which helps to protect bone, also can be used to treat osteoporosis.

In men, decreasing function in the testicles and loss of sex hormones, estradiol or testosterone, may increase the risk of osteoporosis.

Bone loss can occur because of the damaging effects of extra cortisol, produced naturally, or because of the long-term effects of steroids (corticosteroid medications). Cushing's syndrome, for example, can occur when the adrenal glands produce excess cortisol in the body. Sometimes this happens because of a tumor. Cushing's syndrome can also develop if a person is taking steroids such as prednisone and cortisone. These anti-inflammatory medications are used often to treat rheumatoid arthritis, lupus, and asthma.

Other hormonal conditions that may increase the risk of osteoporosis include an overactive thyroid gland, type I diabetes, or hyperprolactinemia, which results in the overproduction of the hormone prolactin by the pituitary gland.

Thyroid cancer survivors who take large doses of thyroid hormone also have a higher risk.

Abnormal function of the ovaries brought on by too much exercise or stress may lead to bone loss.

Eating disorders, especially anorexia nervosa, increase the risk of osteoporosis. Bone loss occurs partly because of poor nutrition and partly because the ovaries stop functioning normally, producing less estrogen.

Who is at Risk for Osteoporosis?

According to the National Osteoporosis Foundation (NOF), osteoporosis is a major public health threat for more than 44 million Americans — or 55 percent of those 50 years of age and older. About 10 million individuals in the United States already have the disease and almost 34 million more have low bone mass, placing them at risk for osteoporosis. Eighty percent of those affected by osteoporosis are women.

Excessive bone loss occurs more often in certain populations. Your risk of developing osteoporosis is higher if you:
  • Are older
  • Have a family history of osteoporosis
  • Have a thin or small frame
  • Have completed menopause
  • Do not have menstrual periods
  • Have anorexia nervosa or other eating disorders that result in poor nutrition
  • Have an inactive lifestyle
  • Have a diet low in calcium
  • Have inadequate amounts of vitamin D in your diet
  • Are a man with low testosterone (hypogonadism)
  • Are Caucasian or Asian, although African-Americans and Hispanics also are at risk
  • Smoke cigarettes
  • Drink too much alcohol
  • Use certain medications, including some anti-seizure medication, high levels of thyroid hormone, or steroids
  • Have certain hormonal conditions*

*Courtesy of The Hormone Foundation
For more information go to: http://www.hormone.org/Osteoporosis/osteoporosis.cfm

More Osteoporosis Links:

International Osteoporosis Foundation
National Osteoporosis Foundation
National Osteoporosis Society
Osteoporosis and Related Bone Disease National Resource Center
Osteoporosis Online

We are not responsible for the contents provided in the links.  If you have questions about the content of these links, please contact the organization directly.