Osteoporosis is a disease that thins and weakens bones to the point where they break easily--especially bones in the hip, spine, and wrist. Osteoporosis is called the "silent disease" because you may not notice any symptoms. People can lose bone over many years but not know they have osteoporosis until a bone breaks. About 25 million Americans have osteoporosis--80 percent are women.

Experts do not fully understand all the causes of osteoporosis. They do know that when women go through menopause, levels of the female hormone estrogen drop. Lower hormone levels can lead to bone loss and osteoporosis. Other causes of bone loss and osteoporosis include a diet too low in calcium and not getting enough exercise.

Who Gets Osteoporosis?

One out of two women and one in eight men over age 50 will have an osteoporosis-related fracture. White and Asian women are most likely to get osteoporosis. Women who have a family history of osteoporosis, an early menopause, or who have small body frames are at greatest risk. Men have less risk of getting osteoporosis because they do not have the same kinds of hormone losses as women. Osteoporosis can strike at any age but the risk increases as you get older.

Diagnosis

Losing height or breaking a bone may be the first sign of osteoporosis. Doctors use several different tests to find osteoporosis. The dual energy x-ray absorptiometry (DEXA) is the most exact way to measure bone density in the wrist, hip, and lower spine. Other tests the doctor may use include single photon absorptiometry, dual energy absorptiometry, and quantitative computed tomography. Ask your doctor about these tests if you think you are at risk for osteoporosis.

Prevention

Osteoporosis is preventable. A diet that is rich in calcium and vitamin D and a lifestyle that includes regular weight-bearing exercise are the best ways to prevent osteoporosis.

Calcium. Getting enough calcium throughout life is important because it helps to build and keep strong bones. Men and women age 25 to 65 should have 1,000 milligrams (mg) of calcium every day. Women near or past menopause should have 1,500 mg of calcium daily. Make foods that are high in calcium part of your diet. Healthy foods that are rich in calcium are:

• low-fat dairy products such as cheese, yogurt, and milk
  
• canned fish with bones you can eat, such as salmon and sardines
  
• dark-green leafy vegetables, such as kale, collard, and broccoli
  
• breads made with calcium-fortified flour.

If you don't get enough calcium from your food, you might think about taking a calcium supplement. Always check with your doctor before taking any dietary supplement.

Vitamin D. Your body uses vitamin D to absorb calcium. Being out in the sun for even a short time every day gives most people enough vitamin D. You can also get this vitamin from supplements, as well as from cereal and milk fortified with vitamin D.

Exercise. Exercise builds bone strength and helps prevent bone loss. It also helps older people stay active and mobile. Weight-bearing exercises, done on a regular basis, are best for preventing osteoporosis. Walking, jogging, and playing tennis are all good weight-bearing exercises. Always check with your doctor before starting an exercise program.

Treatment

Treatment of osteoporosis aims to stop bone loss and prevent falls. Falls often cause broken bones that can mean a trip to the hospital or a long-term disabling condition. Osteoporosis is the cause of 1.5 million fractures each year, including more than 300,000 hip fractures.

Doctors sometimes prescribe estrogen to replace the hormones lost during menopause and to slow the rate of bone loss. This treatment is called hormone replacement therapy (HRT). HRT also protects against heart disease and stroke. However, experts do not know all the risks of long-term use of HRT.

Women should discuss benefits, risks, and possible side effects of HRT with their doctors. Calcitonin is a naturally occurring hormone that increases bone density in the spine and can reduce pain of fractures. It comes in two forms--injection or nasal sprays. You can also ask your doctor about the drug alendronate. This drug increases bone mass in women past menopause.

The best way to prevent osteoporosis is to be aware of the disease and to live a healthy lifestyle. If you think you might be at risk for osteoporosis, talk to your doctor. Ask about the bone density tests available in your area and your prevention and treatment choices.

Resources

National Osteoporosis Foundation
1150 17th Street, NW, Suite 602
Washington, DC 20036-2226
1-800-223-9994

National Resource Center on Osteoporosis and Related Diseases
1-800-624-BONE (2663)
TTY (202) 223-0344

For a list of free publications from the National Institute on Aging (NIA), contact:

NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
(1-800-222-4225 TTY)
E-mail:niainfo@access.digex.net

Information provided by NIH.