Osteoporosis is a very common condition in older women. However, many people do not realize the devastating consequences of untreated osteoporosis, falls, and broken bones. While certain risk factors for the condition are unavoidable for some women, there are actions that people can take to decrease their chances of developing the condition and its consequences. Read more to understand healthy aging amidst the risk for osteoporosis.
Causes of Osteoporosis
Osteoporosis is a skeletal condition that is caused by bone loss and increased risk for fractures. Osteoporosis is especially linked to menopause. Estrogen is a sex hormone that is elevated in women of child-bearing age. Estrogen protects bone density by stimulating the cells that make bones and inhibiting the cells that degrade bones. Menopause causes a sharp decrease in estrogen, therefore decreasing the protection the bones used to enjoy. This causes bone resorption, decreased bone density, and ultimately increase fracture risk.
In some people, osteoporosis can be due to secondary causes such as medication side effects. Common medications that are associated with osteoporosis are anticonvulsants, L- thyroxine, glucocorticoids, anti-coagulants, and proton pump inhibitors for heartburn. Lastly, osteoporosis is often associated with late stage kidney disease due to the changes in calcium in the blood.
Osteoporosis is both due to genetic and environmental risk factors. For example, risk factors for this condition include cigarette smoking, family history of osteoporosis, malnutrition, and low body weight.
Osteoporosis is typically diagnosed with something called a DEXA scan. DEXA stands for Dual-Energy X-ray Absorptiometry. The scan calculates the density of the bones. Bones that are less dense, or 1 to 2.5 standard deviations below the mean, are diagnosed with osteopenia. This means that their bones are less dense and they are at risk of developing the more serious condition, osteoporosis. Osteoporosis is diagnosed with a DEXA scan score of 2.5 or greater standard deviations below the mean. Generally, all women age 65 and older and men 70 or older should get a DEXA scan.
Treatment of Osteoporosis
Treatment first starts with life-style measures. First, people with osteoporosis should avoid alcohol and nicotine. They should also be sure to take in enough calcium and Vitamin D, either through diet or supplements. They should also avoid glucocorticoids, commonly referred to as steroids. Lastly, one often overlooked measure is physical activity. Physical activity, especially weight-bearing exercises, are a major way to prevent osteoporosis and reduce the likelihood of falls and poor outcomes. Weight-bearing and strengthening exercises help increase core strength to reduce the risk of falls.
There is also medical therapy to treat osteoporosis. If a person has a history of fractures due to bone fragility in addition to a DEXA scan of -2.5 or lower, a physician may consider starting them on medical therapy. Medical therapy includes bisphosphonates, a medication that inhibits bone resorption. The side effect of bisphosphonates is esophagitis, or inflammation of the esophagus. These pills should always be taken while the patient is upright
for at least 30 minutes, with plenty of water. Another medical option is a selective estrogen receptor modulator (SERM) called raloxifene. Raloxifene is a great option for people who have a risk for breast cancer and have osteoporosis as it decreases the risk for both. However, it also increases the risk for blood clots. People who have blood clots should avoid Raloxifene.
Estrogens, often in combination with progestogen therapy, is another option that is often used in post-menopausal women. Since estrogen protects bones from resorption and encourages their density before menopause, it does the same after. Additionally, hormone therapy has the added benefit of helping menopausal women with their menopausal
symptoms. However, hormone therapy has side effects and should not be used in certain women. Specifically, it should not be used in people with a history of certain cancers, cardiovascular disease, or blood clots.
Consequences of Untreated Osteoporosis
The dreaded consequence of osteoporosis is falls with subsequent fracture. Medical literature shows that falls in the elderly lead to a variety of worse outcomes. For example, increased mortality, increased hospitalizations, immobility, respiratory infections, internal trauma, and brain bleeds are just some of the consequences. Physicians avoid falls in the elderly whenever possible.
Osteoporosis is a very common disease in older people, especially women. While many people have heard of it, they may be less familiar with the devastating outcomes of untreated osteoporosis. Thankfully, there are a variety of treatment options including pharmacological and lifestyle treatments. Contact us today at the Anti-Aging and Wellness Clinic to learn more about leading a healthy lifestyle and avoiding osteoporosis.