| National Women's Health
Network Fact Sheet
Osteoporosis
Introduction
In the United States, fractures
from osteoporosis are an important health
problem. White women have
a 16% chance of hip fracture; in contrast,
the risk for African-American
women is a much lower 6%. Risks for
Asian American and Native
American women are believed to be in
between these two extremes.
Hip fractures occur at an average age of 80
and recovery is very difficult.
Many women who survive the initial
treatment are unable to
live independently after a hip fracture. Vertebral
fractures occur more frequently
and at slightly younger ages and can
also result in pain and
limited mobility.
More About Bone Density
Both men and women begin
to lose bone at about age 35 and lose
steadily as they get older.
Only about 15% of the bone lost by women is
believed to be sensitive
to estrogen. Estrogen-related bone loss occurs
relatively quickly in the
first few years after menopause. Bone density
screening performed around
this time can accurately measure bone
density, but should not
be relied upon to predict ultimate risk of fracture,
which typically occurs 25-30
years later.
Bone density screening can
more accurately predict the risk of fracture
for white women in their
60's or older. The older models developed so far
have been based on white
women, and have not yet been shown to
accurately predict risk
in women of color. For example, Asian women are
not as likely to fracture
as are white women at the same bone density.
Do You Need Bone Density
Screening?
The NWHN disagrees with recommendations
to screen all
post-menopausal women. Women
who are considering bone density
screening should first evaluate
their risk of fracture. If risk is increased,
modifiable risk factors
like diet, exercise, and home safety should be
addressed first. If a significant
number of non-modifiable risks exist,
particularly the use of
bone-thinning drugs, family history, and loss of
ovarian function before
age 40, bone density screening may be useful to
assess the precise level
of risk faced by an individual woman.
Currently, "low" bone density
is defined as levels significantly less than
normal for healthy young
adults, which results in nearly all older women
eventually being diagnosed
with osteoporosis. The NWHN disagrees with
this definition and recommends
that women ask for their bone density
levels to be compared with
women of the same age when predictions of
risk are made.
Women of color are less likely
to need bone density screening than are
white women. If it is used,
results should be interpreted cautiously.
How To Increase Bone Density
or Slow Bone Loss Without Drugs
* Exercise - weight bearing
activity builds bone
* Eat a high calcium diet
* Avoid excessive protein,
caffeine
* Keep your ovaries as long
as possible
* Stop smoking
How To Prevent Fractures
* "Fall proof" your home
* Avoid long-acting tranquilizers
* Exercise - can improve
balance
* Avoid excessive alcohol
If You Are Considering
Drug Treatment or Prevention
Estrogen Replacement Therapy
has been shown to prevent accelerated
bone loss at menopause.
Women who continue taking estrogen for many
years have fewer fractures.
Women who stop using estrogen, even after
periods as long as 7 years
on the drug, immediately begin to lose bone
at the rate it would have
been lost earlier. Protection against fractures
persists for a few years
after discontinuing the drug, but not long enough
to prevent serious fractures
when they are most common. If hormone
therapy is begun around
the time of menopause, it must be continued for
20 years or more. However,
long-term users of estrogen have increased
risks of breast cancer,
surgery for gallbladder disease, and possibly fatal
ovarian cancer. Adding progesterone
to estrogen eliminates the
increased risk of endometrial
cancer caused by estrogen alone and
doesn't seem to interfere
with its effect on bone.
Fosamax is a non-hormonal
drug, which may be safer than estrogen. It
was first shown to prevent
non-menopause associated bone loss in
women who were, on average,
65 years old. A similar trial with younger
women also found that the
drug delays bone loss in women who recently
completed menopause. Women
considering Fosamax for long-term
treatment should be aware
that its long-term safety is not yet known.
Evista or raloxifene is the
first of several new "designer estrogens"
intended to prevent osteoporosis
without increasing cancer risks in
post-menopausal women. Evista
is believed to work as a "partial"
estrogen, and is often described
as a Selective Estrogen Receptor
Modulator (SERM). Ideally,
a SERM such as raloxifene is supposed to
positively affect the heart
and the bone (increasing bone mass by about
2%), without any negative
effects on the breasts and uterus. A study of
1,800 post-menopausal women
is still ongoing in order to determine
Evista's long-term benefits
and risks. Women should know that even
though Evista has been approved
by the FDA for treatment of
osteoporosis, there are
still many questions that can only be answered
after a long-term study
is evaluated.
Credit: Women's
Health Network |
Minnie
Pauz knows how to protect herself from hip fractures!
Comments
 "It
is well established that estrogen replacement during menopause protects
bone mass and helps protect against the risk of osteoporotic fractures.
The
accelerated bone loss during menopause has little relationship to the amount
of calcium intake. After age 60, however, the proper attention to calcium
intake is very important and has been shown to increase bone density. An
important study published in 1992 showed that elderly women who took supplemental
dietary calcium (with vitamin D) had a 30% less fractures (including hip
fractures) than similar women who did not take supplemental calcium." SOURCE
"For
better bones, take 500 mg magnesium (not citrate) with your calcium. Better
yet, wash your calcium pill down with a glass of herbal infusion; that
will provide not only magnesium but lots of other bone-strengthening minerals,
too. Calcium supplements are more effective in divided doses. Two doses
of 250 mg, taken morning and night, actually provide more usable calcium
than a 1000 mg tablet." SOURCE
Helpful Links
Minnie Pauz Links:
35
Symptoms
About
Calcium
National
Osteoporosis Foundation US
National
Osteoporosis Society UK
Understanding
Osteoporosis
The
National Women's Health Information Center
|
