Osteoporosis Overview

Osteoporosis is a condition in which the thickness and strength of bone decrease to the point where bones can easily break causing a fracture. Osteoporosis is a silent disease. There may be no symptoms until a bone breaks. Bones that are weakened by osteoporosis are easily broken, even by a minor injury. These types of fractures occur most commonly at the wrist, spine, hip as well as other areas. Spine fractures result in collapse of bone, leading to stooped posture (“dowager’s hump”), loss of height, and back pain.

Who is at risk?

In general, older women who are past menopause have the highest risk for osteoporosis and fractures.

• Half of all postmenopausal women will have an osteoporosis-related fracture in their lifetimes.
• Your chances of having osteoporosis increase with age.
• White women are at higher risk, but osteoporosis is also common in other racial/ethnic groups.

What are some of the other common risk factors?

• Previous low-trauma fracture after age 50.
• Use of certain medications.
• Existence of certain other illnesses.
• Not using estrogen after menopause.
• Low weight.
• Low intake of calcium and vitamin D.
• Smoking, excessive alcohol use.
• Family history.
• Poor physical activity or function, history of falls

How can you prevent osteoporosis?

Your bones are strongest during your twenties, but it is never too late to take steps to keep your bones strong as you get older:

• Get plenty of calcium in your diet (1,000-1,500 mg per day). Many older people get only about 500 mg per day. Talk with your clinician about taking calcium supplements if you are not getting enough in your diet. The best source of calcium is low-fat dairy products: a cup of low-fat yogurt contains about 442 mg, a cup of skim milk contains about 313 mg, one ounce of cheese contains about 200mg. Smaller amounts of calcium are also found in kidney beans, broccoli, greens, and other foods.
• Get enough Vitamin D (400-800 units per day). Vitamin D is obtained by sunlight exposure and is available in milk and multivitamin tablets.
• Get regular weight-bearing exercise such as walking, bicycle riding, or dancing. Bones get stronger with exercise and exercise helps improve coordination and strength, which will reduce your risk of falls and injuries.
• Don’t smoke, and drink alcohol in moderation, if at all (one drink or less per day).
• Reduce risks for falls by correcting visual problems, removing hazards from home such as loose rugs, and using aids to walk if necessary.
• Reduce medications that cause bone loss if appropriate alternatives are available. Your clinician can help review your medications with you.
• Discuss the risks and benefits of estrogen replacement therapy with your clinician when going through menopause. This is especially important for women undergoing early menopause (before age 45) whether it occurs naturally or from surgical removal of the ovaries.

What is bone density testing?

Bone density tests measure the thickness of bone using a narrow X-ray beam. Bone density test results can help determine risk of fracture in older women. Studies have shown that women with low bone density may be good candidates for medications that can increase or stabilize bone density and prevent fractures. To determine if bone density testing is appropriate for you, discuss this with your clinician.

In general, bone density testing is useful for:

• All women age 65 and older who have not had a bone density test
• Women under age 65, if they have many risk factors or have had a previous fracture.
• Some men, if they have had previous fractures, are on certain medications, or if they have certain other medical problems.

How can you reduce the effects of osteoporosis if you have it?

Several medications are now available to reduce fractures in women with osteoporosis. These are discussed in detail in the BONE UP/date newsletter from the Oregon Osteoporosis Center.

Last updated: July 2002