Women in Motion

Susan Blatt, MD

Osteoporosis causes bones to be fragile and tends to occur in older adults.  It is more common in women than in men.  Fractures caused by osteoporosis can result in disability and disease; consequently it is important to prevent osteoporosis, if possible.

There is activity within living bone, with minerals constantly entering and leaving.  In children and young adults, calcium is added and bones become stronger and this process reaches a peak at around age 30.  In older persons, more calcium leaves than enters and this results in thinning and weakness of the bones.  Risk factors for osteoporosis include being female, getting older, being thin, smoking cigarettes, being physically inactive, eating a diet low in vitamin D and calcium and early menopause.

In a person with osteoporosis fractures may occur with a slight fall or there may be no fall at all.  The three locations commonly affected are the wrist, the hip, and the vertebral column.  The most common wrist fracture is a fracture of the radius, called a Colles fracture.  It is painful and can result in deformity, even when it is treated appropriately by an orthopedist.

Hip fractures often occur in the neck of the femur resulting in immediate inability to walk.  In the past, treatment involved weeks of traction, but now these fractures are pinned or an artificial joint is used.  The vertebral fracture of osteoporosis is a compression fracture of the spool-like vertebrae.  This causes mild or severe back pain, hunchback deformity, and shortening of stature.

The test for osteoporosis is a type of x-ray, called bone densitometry.  While the patient lies still on a table an x-ray machine examines the hip, the spine, or another bony area, to see how dense the bone is.  The test takes about a half an hour and it is painless.  It is recommended for all women in their 60’s.

To prevent osteoporosis, a person should be active, getting at least a half hour of vigorous activity every day.  Daily vitamin D and calcium supplements should be used, under the guidance of a physician. Estrogen supplements are no longer routinely recommended for osteoporosis prevention, but some similar medications do have the effect of preventing osteoporosis without having the negative effects of hormones.  In order to prevent falls, it is helpful to modify the house with grab bars in the bathroom, nightlights, and checking for loose throw rugs.

If a woman is found to have osteoporosis, or the more severe form called osteopenia, all of the preventive approaches should be put in place.  The patient’s doctor can determine the best medication for each individual situation.

Men may also develop osteoporosis, but generally later in life than women.  Risk factors for men include excessive consumption of alcohol, use of steroids, and decreased testosterone.  Many people have had organ transplants and must take steroids throughout their lives.  People may also take steroids for arthritis, asthma, and skin conditions and these people are at increased risk of fractures due to osteoporosis.

Preventing and treating osteoporosis is important, as we age, to make sure we remain free of fractures into our older years.