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Osteoporosis in women

Osteoporosis is pretty specific disease of weakened bones – it is actually the increased loss of bone mass and strength. When we grow, bones form faster than resolve. With aging (after 35-40) processes in human bones reverse – bone breakdown begins to outpace bone buildup, resulting in a gradual loss of bone mass. With aging we start losing certain amount of bone material, bones become less dense and less strong. Once bones lose reach certain point, osteoporosis starts. In weakened bones number of “holes” grows and these “holes” become larger (weakening strong bone stricter). Weakened bones could cause bones break and painful fractures commonly in the back or hips. Special attention should be paid to osteoporosis in women.

Unfortunately women lose bone material more rapidly compared with men (especially after 50 during menopausal estrogen deficiency). Several studies confirm that estrogen can protect bones and prevent bone loss. This is why women start suffering from osteoporosis during perimenopause and menopause. If women suffer from hypoestorgenia (estrogen deficiency) during reproductive period of life, they also can develop abnormal loss of bony tissue. It could happen during different types of amenorrhea (absence of menstrual periods), premature ovarian failure, hypogonadotropic hypogonadism, hyperprolactinemia, anorexia and premature menopause.

Abnormal loss of bony tissue was noted in 68% aging women and only in 32% aging men.

After 50 one of every two women is at risk of bones fracture due to osteoporosis.

In total 75% of all cases of hip osteoporosis affect women.

Symptoms

In general, bones loss (bones thinning) processes develop slowly over several years and occur without any visible symptoms. This is why osteoporosis is considered as typical silent disease – people start thinking about bone problems only after bones fracture or collapse of vertebrae. In cases of bones loss even minor injury such as a fall can trigger fracture (so called “fragility fracture”). Commonly fragility fractures occur in hip, wrist and vertebrae.

Osteoporosis in women

Typical symptoms include the following:

  • Severe persistent non-stop back pain,
  • Loss of height (unexpected decreased height),
  • Spinal deformations,
  • Stooping posture (in cases of one or more fractured vertebrae).

Risk factors

Being a woman over the age of 50 – lighter thinner bones, estrogen deficit and longer life spans increase risks;

Aging – bones masses begin natural declining with aging;

Hormonal dysfunctions with estrogen deficiency – different types of amenorrhea, premature ovarian failure, hypogonadotropic hypogonadism, hyperprolactinemia, anorexia and premature menopause.

Genetic factors – if family members suffer from bone losses and fractured hip, it could increase chances for disease;

Ethnical origin – Caucasian and Asian women are more likely to develop abnormal loss of bony tissue;

Bones structure and Body Mass Index less than 18.5 – small tinny women have less bones to lose and anorexic women suffer from estrogen deficiency;

Vitamin D deficiency – lack of calcium and vitamin D due to limited sun exposure and poor diet;

Unhealthy addictions – smoking, drinking and drug abuse;

Immobile lifestyle – forced wheelchair or habitual (psychological) lack of physical activities;

Certain diseases – cancer, stroke, hyperthyroidism, Cushing ‘s syndrome, chronic kidney and liver disease, rheumatoid arthritis, type 1 diabetes and Coeliac disease.

Certain long-term medications – steroids (prednisolone, cortisol).

Osteoporisis

Diagnostic tests

DEXA scan, bone mineral density (BMD) tests and bone measurements can identify abnormal loss of bony tissue.

Prevention measures

Physical activities and exercises (fitness, walking, jogging, sports, dancing) which make bones and muscles stronger and help prevent bone loss;

Diet rich in calcium – milk and dairy products, canned fish with bones, dark green leafy vegetables and calcium-fortified products;

Vitamin D and calcium supplements (prescribed by medical doctors);

Stop all unhealthy habits such as smoking, drinking and drug abuse;

Hormone replacement therapy (HRT) when needed.

Treatment

Treatment modules should be developed by qualified medical experts. Several treatment components can be implemented:

Specific medications – alendronate (Binosto, Fosamax), ibandronate (Boniva), raloxifene (Evista), risedronate (Actonel, Atevia) and zoledronic Acid-Water (Reclast, Zometa);

Vitamin D and calcium supplements (properly calculated doses based on blood tests);

Physical activities (weight bearing exercises which make body muscles work against gravity);

Injectables for rebuilding bones – abaloparatide (Tymlos), teriparatide (Forteo), denosumab (Proliageva, X) or PTH;

Hormone therapy (hormone replacement therapy).


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