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In osteoporosis, the inside
of the bones becomes porous from a loss of calcium (see the
picture below). This is called losing bone mass. Over time,
this weakens the bones and makes them more likely to break.
Osteoporosis is much more common in women than
in men. This is because women have less bone mass than men,
tend to live longer and take in less calcium, and need the
female hormone estrogen to keep their bones strong. If men
live long enough, they are also at risk of getting osteoporosis
later in life.
Once total bone mass has peaked around age 35all
adults start to lose it. In women, the rate of bone loss speeds
up after menopause, when estrogen levels fall. Since the ovaries
make estrogen, faster bone loss may also occur if both ovaries
are removed by surgery.
You may not know you have osteoporosis until
you have serious signs. Signs include broken bones, low back
pain or a hunched back. You may also get shorter over time
because osteoporosis can cause your vertebrae (the bones in
your spine) to collapse. These problems tend to occur after
a lot of bone calcium has already been lost.
See the box to the right for a list of
things that put you at risk for osteoporosis. The more of
these that apply to you, the higher your risk is. Talk to
your family doctor about your risk factors.
Check with your doctor. For many women, osteoporosis
(or the risk of it) can be diagnosed without testing. When
testing is appropriate, doctors use equipment that takes a
“picture” of the bones to see if they are becoming
porous.
Hormone replacement therapy (HRT) is one way
to prevent osteoporosis or keep it from getting worse.
In HRT, you take hormones (estrogen and progestin
together, or estrogen alone) to counteract the drop in estrogen
that happens at menopause or when the ovaries are removed
by surgery.
Women who take HRT are at an increased risk
for breast cancer, heart attack, stroke, serious blood clots
and Alzheimer's disease.
Many physicians now recommend that their patients
on HRT stop taking it to prevent osteoporosis.
Factors such as your health history and your
family’s health history will be important when weighing
the risks and benefits of HRT. Talk to your doctor about whether
it’s right for you.
Calcitonin (some brand names: Calcimar, Miacalcin)
is a hormone that helps prevent further bone loss and reduces
the pain that some people have with osteoporosis.
Calcitonin can be taken as a shot or as a
nasal spray. Its most common side effect is nausea.
Ibandronate sodium (brand name: Boniva) is a
new drug that is taken once a month. It is not a hormone,
but it slows bone loss and increases bone density. Some of
the possible side effects include upset stomach, heartburn,
nausea and diarrhea.
Alendronate (brand name: Fosamax) and risedronate
(brand name: Actonel) are not hormones, but are used to help
prevent and treat osteoporosis. These drugs help reduce the
risk of fractures by decreasing the rate of bone loss. Their
most common side effect is an upset stomach.
Raloxifene (brand name: Evista) is a drug used
to prevent and treat osteoporosis by increasing bone density.
It is not a hormone, but it mimics some of the effects of
estrogen. Side effects may include hot flashes and a risk
of blood clots
Teriparatide (brand name: Forteo) is a new injectable
synthetic hormone used once a day for the treatment of osteoporosis.
It causes new bone growth. Common side effects may include
nausea, dizziness and leg cramps.
Before menopause, you need about 1,000 mg of
calcium per day. After menopause, you need 1,000 mg of calcium
per day if you're taking estrogen and 1,500 mg of calcium
per day if you're not taking estrogen.
It’s usually best to try to get calcium
from food. Nonfat and low-fat dairy products are good sources
of calcium. Other sources of calcium include dried beans,
sardines and broccoli.
About 300 mg of calcium are in each of
the following: 1 cup of milk or yogurt, 2 cups of broccoli,
or 6 to 7 sardines.
If you don’t get enough calcium from the
food you eat, your doctor may suggest taking a calcium pill.
Take it at meal time or with a sip of milk. Vitamin D and
lactose (the natural sugar in milk) help your body absorb
the calcium. |
