Osteoporosis is a condition characterised by loss of calcium from the bone matrix. It is typically a disease of post-menopausal women and elderly males. Although it tends to affect both males and females, females are more prone to the adverse effects of osteoporosis due to the following reasons:
1. Women have less bone mass to start with. Therefore they are more liable to lose calcium from bones.
2. Both testosterone and estrogens are important for bone health. But unlike women there is nothing like male menopause (At least not as a distinct clinical entity). Therefore women who are post-menopausal lose bone mass rapidly.
Before we go into the details of osteoporosis, it would serve us well to understand the basics of bone mineral metabolism. The bone is a dynamic structure consisting of organic and inorganic elements. The organic elements consist of collagen and elastin, while the inorganic elements consist of calcium and phosphate. Nearly 90% of body's calcium is present in bone and this calcium is constantly turned around. The bone as mentioned earlier is a dynamic structure. Everyday old bone is destroyed and new bone formed. The maximum bone mass is achieved by 30 years of age. Beyond this there is a constant decrease in the bone mass.
The female hormone oestrogen plays a major role in bone mineral metabolism. It is primarily responsible for the lengthening and closure of the epiphysis. It is also responsible for maintaining the overall bone health in women. Therefore after menopause when the levels of estrogens fall the loss of bone mass is accelerated. This is the reason why osteoporosis is fairly common amongst the post menopausal women.
There are many other causes for osteoporosis. Some of the major causes include:
1. Poor nutrition
2. Prolonged steroid use (greater than three months cumulative)
3. Hormonal disorders like Cushing's disease and hyperthyroidism.
Having understood a bit of bone mineral metabolism, let us now turn to the symptoms of osteoporosis. Osteoporosis per se has no specific symptoms. Women with osteoporosis may have vague non specific symptoms like fatigue, weakness and pain in bones. But these are not very specific and it is not possible to diagnose osteoporosis on the basis of these symptoms alone. The major problem with osteoporosis is the high risk of fractures it confers on women. Since the bones become weak due to loss of calcium, osteoporotic bones tend to become weak and break with trivial trauma. For example, most of us may not break a bone in a simple fall, but osteoporotic women may sustain fractures with even trivial falls. This is the major problem with osteoporosis. Apart from this, osteoporotic bones also heal poorly leading to delayed union or malunion.
Osteoporosis is diagnosed by measuring the bone density. The bone density is measured by a scan called DEXA scan. DEXA scan report bone density as standard deviations from normal. If a woman has -2 S.D then osteoporosis is diagnosed.
Once osteoporosis is diagnosed treatment should be instituted immediately. Treatment essentially consists of
1. Calcium supplements
2. Use of Biphosphonates
3. Fall prevention
A complete and detailed discussion of the management of osteoporosis is beyond the scope of this article and it may be found in my website. There is also an article on exercises for osteoporotic women and prevention of falls which you may find useful.
To conclude it is important to aware about the causes and prevention of osteoporosis as it can lead to serious problems later on in life. Prevention is more important because osteoporosis is rarely symptomatic, but can cause serious complications like fracture which heal poorly. Therefore be aware of osteoporosis.
Dr Sriram Ravichandran is specialized in women health issues and hosts a popular website http://www.pregnancyandchildcare.info on pregnancy and parenting issues. He has been guiding many women towards an healthy pregnancy and parenting for years. Do visit his website for high quality relevant information on pregnancy and parenting