Breaking the silence around osteoporosis
An estimated 10 million Americans — 80 percent of them women — have osteoporosis.
What is osteoporosis?
Osteoporosis is a weakening of bones that makes them more prone to fractures. As we age, especially after menopause for women, the minerals in our bones can become less dense, to the point that even a low-impact injury can cause a break called a fragility fracture.
"Our goal is to prevent that," says Dr. Tricia Markusen, a Montage Health obstetrician/gynecologist. "Osteoporosis is a silent disease. We don’t know if somebody has low bone density unless they start sustaining fragility fractures as they get older."
Bone-density testing for osteoporosis
An important tool to help break that silence is a bone-density test, which uses low-dose X-rays to measure bone loss. The analyzes your bone density and gives a result called a T-score. The test can:
- Identify bone-density decreases before you break a bone
- Determine your risk for broken bones
- Confirm whether you have osteoporosis
- Be a baseline for monitoring loss in bone density
"Knowledge is power," Markusen says, "and we want people to be proactive about their health. Learning about your bone density helps you be proactive."
Many people may put off this test, Markusen says, because they incorrectly assume it's done in an enclosed scanner. In reality, the patient lays on a table and scanners pass above and below them.
"Unlike a CT scan or most MRI scans, it’s non-enclosed," Markusen says. "You lie flat on the machine, so it’s non-invasive, not uncomfortable or intimidating, and the entire procedure only takes 15 to 20 minutes."
Osteoporosis screening
The Bone Health & Osteoporosis Foundation recommends bone-density testing for:
- Women ages 65 or older and men ages 70 or older
- People who break a bone after age 50
- Postmenopausal women with risk factors
- Men ages 50–69 if they have risk factors
What causes osteoporosis?
Risk factors include family history of osteoporosis, being small and thin, and broken bones or height loss. Other causes can include:
- Low testosterone and hormone imbalances
- Having a diet low in calcium and vitamin D
- Lack of exercise, especially weight-bearing activities
- Smoking and excessive alcohol use
- Certain medical conditions and medications
Bone density typically remains stable until women go through menopause, at which point they become estrogen-deficient. After menopause, they can lose 2–4 percent of bone density per year.
Men also can develop osteoporosis, but they rarely experience a dramatic decrease in bone density as they age unless they take certain medications, such as prednisone or other steroids.
"If a man is being treated for prostate cancer," Markusen says, "and he's taking medications that lower his testosterone, he may be at increased risk of developing osteoporosis."
Adolescents with eating disorders like bulimia or anorexia risk not developing peak bone mass during their lifetimes and might be more prone to developing osteoporosis later in life.
"There's also a genetic component to osteoporosis," Markusen says. "If your parents or grandparents had osteoporosis, you might be at greater risk for developing it."
Treatments for osteoporosis
"If a woman is experiencing significant hot flashes or other menopause-related symptoms," Markusen says, "she might want to consider hormone therapy to prevent or delay further bone loss."
Supplements like calcium or vitamin D can also be helpful, but Markusen cautions against overusing calcium because of increased risk for developing kidney stones or calcification of coronary arteries.
"If someone has fragile bones," Markusen says, "we can try medications like bisphosphonates, which maintain bone density by slowing the rate at which bone breaks down."
