 Photo Source: ecs.lewisham.gov.uk The hormone estrogen plays an important role in keeping women’s bones strong. After menopause, a woman’s body produces much less estrogen, so the bones tend to grow weaker. Surgical removal of the ovaries will also immediately reduce estrogen levels.
There are tests to determine whether you have or are developing osteoporosis and effective treatments that can help slow down bone loss. There are also steps you can take long before osteoporosis occurs to reduce your risk of developing the disease.
The symptoms of osteoporosis
The spine is a common area for bone loss. Over time, the vertebrae (spinal bones) may gradually collapse on themselves, leading to back pain, loss of height, and stooped posture.
Sometimes, there are no symptoms at all until a bone breaks. This is why it is so important to start safeguarding against bone loss long before menopause occurs. Peak bone mass occurs between the ages of 25 and 35. As you grow older, more bone is removed than is replaced. It is never too late to begin taking steps to increase bone mass or prevent future loss.
How can you find out if you have osteoporosis?
Your doctor will review your medical history and symptoms, perform a physical exam, and order blood tests and x-rays. If you are in one of the high-risk groups, you will probably be given a bone density test that measures your bone mass in the hip, spine, heel, or wrist. If the bone mineral content is below normal, you may have osteoporosis.
Treating osteoporosis
The most effective treatment for osteoporosis is estrogen replacement. Estrogen is often prescribed in combination with another hormone, progestin, which helps protect the lining of the uterus. This is called hormone therapy, or HT. Because the greatest amount of bone loss occurs in the first years after menopause, beginning this therapy shortly before menopause is the best way to slow the loss of bone.
There are pros and cons to HT however. On the plus side, HT lowers the risk of hip and other fractures and helps reduce the risk of colorectal cancer. On the other hand, HT can increase the risk of breast cancer-and taking estrogen alone can increase the likelihood of uterine cancer. Additionally, your doctor may not recommend estrogen replacement if you have a history of blood clots, stroke, or heart disease.
If hormone therapy is not advisable for you, there are other medical opinions available that you should discuss with your doctor. These include a medication that helps prevent bone loss and helps increase bone mineral density; a medication that works like estrogen to maintain bone density but without increasing the risk of uterine cancer; and a hormone that helps to reduce bone loss and may increase bone mass.
Before beginning estrogen replacement or any other medical therapy, it is important that you discuss all of the above with your doctor, so that he or she can recommend the treatment that is best for you.
Getting enough calcium, vitamin D, and exercise
All treatments for osteoporosis require adequate daily intake of calcium and vitamin D. Calcium and vitamin D intake are critical in keeping your bones strong. Most premenopausal women should have 1200 milligrams daily, women who are pregnant or breast-feeding need 1500 milligrams, and postmenopausal women require 1500 milligrams.
Most people should get at least 400 International Unit (IU) of vitamin per day. If you are at a risk for osteoporosis, 800 IU are recommended. The main source of vitamin D is sunlight. You can help ensure that you get enough calcium and vitamin D in your diet by eating plenty of low-fat milk and dairy products; green, leafy vegetables; citrus fruits; salmon and sardines (including the bones ); and shellfish . Over-the-counter calcium and vitamin D supplements are also available.
Doing weight-bearing exercise daily is an important way to help reduce bone mineral loss. This can include stair climbing, walking or jogging one to two miles a day, tennis or cross country skiing, or working out with free weights.
Thing s you can do to reduce your risk of bone injury
We’ve described a number of ways you can help prevent osteoporosis. Below are some suggestions for people already dealing with the effects of this condition.
• Avoid lifting heavy objects.
• Build up your activity level gradually. Avoid unusually strenuous exercise.
• Wear low-heeled shoes with no slippery soles for walking and appropriate shoes for sports and recreation.
• Use a cane or other support for walking, if needed.
• Keep your home well-lighted and uncluttered to help prevent falls.
• Avoid the use of throw rugs (they can be slippery).
• Use nonskid mats in the shower and bathtub
• Avoid wet or slippery surfaces, and stay indoors, if possible, when then weather is icy.
Supported as an educational service by Novartis Pharmaceuticals Corporation. This information is not intended for use as medical advice. You should discuss this information with your doctor.
Avaraham Henoch, MD
564 West 160th Street
New York, NY 10032
Phone: (212) 740-6400 |
