OSTEOPOROSIS in Women- Dr. C V Harinarayan , Consultant Endocrinologist, Fortis Hospitals Bangalore

What is Osteoporosis?

Osteoporosis is a disease characterized by exaggerated bone loss wherein the bone becomes fragile and susceptible to fracture. The fragility fracture occurs mainly in the spine, forearm and wrist. Osteoporosis is called a “Silent thief” because the bone loss occurs with no symptoms. Patients with osteoporosis may become severely disabled by pain leading to incapacitation of simple daily activities. Fear of falling may make them inactive and home bound.

Incidence of osteoporosis in India

More than 75 percent of the women beyond the age of 60 years have osteoporosis.

What causes Osteoporosis and who is affected by Osteoporosis?

The specific causes are not known. The risk factors include female gender, small thin frame, older age, early or surgically induced menopause, low dietary calcium, vitamin D deficiency, heavy alcohol use, cigarette smoking, heavy caffeine usage, long term steroid usage etc. Other factors are menopause, Low dietary calcium, use of medications as mentioned above, Rheumatoid arthritis, thyroid replacement therapy

Diagnosis

Osteoporosis is diagnosed by evaluating patient history, life style, daily living habits and measuring bone mineral density. Bone mineral density (BMD) is measured by DEXA (Dual Energy X-ray absorptiometry) which is a SPECIFIC imaging technique for measuring the amount of bone loss and is commonly used in hospitals. Ultrasound Bone Mineral Density (US-BMD) is a screening test which helps to identify those at risk, while DEXA is a specific test for diagnosis.

Treatment

Early diagnosis and treatment is the best approach to preserve bone mass. Medical therapies that slow bone loss and decrease the risk of fracture is currently available. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. Osteoporosis treatment and prevention measures are lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly, and consuming a balanced diet with adequate calcium and vitamin D.

Supplementation with calcium and vitamin D, along with estrogen, calcitonin or bisphosphonates are used in treatment of osteoporosis. In severe cases anabolic agents who form bone namely teriparatide is used as therapy.

Prevention

Inactivity worsens bone loss along with poor dietary calcium intake and being home bound. A comprehensive exercise program is especially important for increasing muscle strength and endurance, increasing flexibility, bone health, balance and stability. Improving body mechanics and posture also helps. Education about self care techniques, independent living skills, methods of conserving strategies for minimizing risk of injury are important. Nutritional it is very important to take adequate amount of calcium from diet and vitamin D from sunlight.

Diabetes and Osteoporosis

Women with diabetes are at increased risk of osteoporosis especially when they enter menopause. Diabetes of long standing duration makes the lose nutrient necessary for building bone.

Vitamin D and Osteoporosis – Deficiency of Vitamin D may lead to Osteoporosis

During menopause (medical or surgical) there is bone loss due to lack of female sex hormone estrogen. When there is deficiency of vitamin D there is poor dietary calcium absorption. Menopause along with vitamin D deficiency accelerates bone loss and osteoporosis.

Bone loss in Elderly

Bone loss occurs after menopause and also with advancing age. Post menopausal osteoporosis and age related osteoporosis are the respective terminologies used. Age related osteoporosis sets in after the age of 70 years and post menopausal osteoporosis after the cessation of menstrual cycles.

Tags: Bone and jointDr Harinarayan, osteoporais

This entry was posted on Wednesday, May 12th, 2010 at 12:56 pm and is filed under Ask a Doctor, Bone and Joints, Diagnosis Treatements. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.