Osteoporosis

Osteoporosis

What is osteoporosis?

Osteoporosis is a condition characterised by a change in the structure of the bones and a reduction in bone mass, which weakens the bone. This makes the bones fragile and the risk of fractures increases. Patients with osteoporosis most commonly experience fractures in the spine, hips and wrists.

 

What are the symptoms of osteoporosis?

In the first stages of osteoporosis, patients rarely experience symptoms. Many people therefore live with osteoporosis without knowing, while the condition gradually gets worse and often ends in a painful fracture.

 

What causes osteoporosis?

Usually, bone density increases up until the age of 25, where the bone density is at its highest. After this age, the bone density will be maintained for around 10 years. At the age of 35, a person will lose 0.5 % of his or her bone mass regardless of gender as part of the body’s ageing process.

During the first 5 – 10 years of menopause, women can lose as much as 5 % of their bone mass a year, because oestrogen levels fall significantly. Oestrogen is essential for healthy bones, and this is why women are more at risk of developing osteoporosis than men, because the hormone changes that occur in the menopause directly affect bone density. Women around the ages of 80 and 90 will typically have lost around 50 % of the bone mass they had at the age of 25.

Several factors might increase the risk of developing osteoporosis. Family history, low body weight (BMI), early menopause, old age, a low intake of calcium and vitamin D, excess alcohol consumption, smoking and being treated with steroid medication.

 

How is osteoporosis diagnosed?

Osteoporosis can be diagnosed with a ‘DEXA scan’ (Dual-energy X-ray absorptiometry), which measures the bone mineral density in the hip bone and spine. The X-ray scan takes about 5 – 15 minutes to perform.

The relation between the measured bone density and the average bone density of a 25-year-old of the same sex, the so-called standard deviation, is called a T score. Osteoporosis is defined as a T score of -2.5 or below.


 

How is osteoporosis treated?

Once a significant portion of the bone mass has been lost, it is difficult to rebuild it. Since osteoporosis affects approximately one third of all women and one in eight men, it is advised that everyone tries to prevent the disease by following advice to increase bone density and to prevent bones from breaking down. It is recommended to get 800-1000 mg of calcium as well as 20-40mg of vitamin D every day via dairy products or as supplements. It is also recommended to avoid smoking and to cut down on alcohol and coffee. In addition, regular exercise for at least 4 hours a week can help strengthen bones significantly.

Once you have developed osteoporosis, different medications can help slow down the rate of which bone is broken down and also stimulate cells that create new bone. These include bisphosphonates, medications containing oestrogen, parathyroid hormone, medications that have a similar effect on bones as oestrogen and many more. The treatment is often combined with calcium and vitamin D supplements. The treatment will often increase bone mass, thereby reducing the risk of fractures by as much as 50 %.

Fractures will often be treated surgically.

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