Osteoporosis is a very common disorder in women and increasingly more recognized in men. It is increasingly being recognized as a very preventable disorder that has potentially devastating consequences if left untreated.
As women go through menopause, the levels of estrogen decrease dramatically. Estrogen is an important component in bone health. Thus, we start to see an increase in the incidence of osteoporosis after menopause. Although men do not technically go through a “menopause”, their levels of testosterone do decrease with age and we are increasingly more cognizant of the incidence of osteoporosis in older men.
There are several significant risk factors for developing osteoporosis: family history, genetics (Caucasians and Asians have the highest risk), smoking, inactive lifestyle, and lack of calcium or vitamin D especially in the younger years when bones are developing.
The gold standard for the diagnosis of osteoporosis is with a bone density scan and recently the addition of checking vitamin D levels in the blood. Bone densitometry is a simple, 10 minute test that measures the density of the bone in the spine and hip, the two most common areas of bone fracture in osteoporosis. The results are compared against a standard of other women who are the same age. There are three classifications based on the results of the bone density test: NORMAL, OSTEOPENIC (or low bone mass), and OSTEOPOROSIS. In patients with normal bone density, we recommend continued adequate calcium and vitamin D intake (800-1200 mg of calcium a day, 800 IU of Vitamin D a day). In postmenopausal women with osteopenia the recommendation for calcium would be 1200-1500 mg a day, and vitamin D 2000 IU a day. In women with osteoporosis the recommendation would be the same as for osteopenia with the addition of one of the newer medications that facilitate the movement of calcium into the bone, such as a bisphosphonate. All three groups are encouraged to stop smoking and start a weight bearing exercise regimen.
The new research and subsequent drugs that are now available to prevent and treat osteoporosis are very exciting. Hopefully we will soon be able to make osteoporotic fractures a thing of the past