Osteoporosis

Osteoporosis

The clinical definition of Osteoporosis is "a condition where there is less normal bone than expected for a woman's age, with an increased risk of fracture." It is a painful, crippling and life-threatening condition and is the single most important health hazard for women with menopause. In its early stages it has no obvious symptoms so women may be unaware, but because of its life-threatening nature every woman should be made aware of it and prevent osteoporosis from occurring.

Why does it occur ?

Estrogen facilitates uptake of calcium into the bones and activates the basic multicellular unit which is responsible for bone remodeling. A decline in estrogen levels after menopause leads to bone disintegration and loss  of  bone  mass by 0.5 to 3% a year. This




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rate will continue for 10- 15 years, after which bone loss is diminished but continues as age related loss. In the first 20 years after menopause there is a 50% reduction in trabecular bone (spine) and 30% of other bone.

Sites of osteoporosis
Distal radius (Wrist)
Thoracic and lumbar vertebrae (Spine)
Collar bone
Hip bone

Reliable indicator to determine the risk of fracture is Bone Densitometry. DEXA (Dual Energy Xray Absorptiometry) is used to measure the bone density. " T score of less than -2.5 and below" is at risk for osteoporosis.

Prevention of osteoporosis

There are a number of ways we can change our lifestyles to help maintain healthy bones. Regular exercises, a balanced diet, physiotherapy, avoidance of smoking and alcohol abuse may help. Women who exercise atleast twice a week have denser bones than those who don't exercise. Diet rich in calcium like dairy products, fish etc. and vitamin D is important for early prevention of osteoporosis. Calcium supplementation 1000gm per day decreases bone loss and fractures.To reduce the risk of fractures hormone replacement therapy should be initiated as close to menopause and must be maintained long term if not life-long.