Osteoporosis is a bone disease that affects more than 50 million people in the U.S. and is particularly common in those over age 50. Experts estimate that half of all women and one in four men over 50 have this condition.
Osteoporosis causes bones to become less dense and more porous and increases the risk of breaking a bone. In fact, most people do not learn they have the disease until they experience a fracture during a minor accident or fall that usually wouldn’t result in such an injury.
Screening is recommended by the U.S. Preventive Services Task Force for all women over the age of 65 and women of any age at increased risk of developing osteoporosis.
Advantia Health Osteoporosis Management
Because menopause, and the significant decrease in estrogen levels it causes, is a major risk factor for osteoporosis, Advantia Health providers are well positioned to help you understand and manage this disease due to their wealth of women’s health-focused knowledge.
While there is no cure for osteoporosis, your provider can assist you in determining and lowering your risk, alleviating symptoms, and strengthening your bones through a personalized treatment plan.
Bone Density Screening
A bone density test can be used to diagnose osteoporosis, detect low bone density before osteoporosis develops, predict the risk of future fractures, and monitor the effectiveness of current treatments for osteoporosis. The most common test for measuring bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA).
The test uses X-rays to measure the amount of calcium and other minerals in a section of bone. The most commonly tested bones are in the spine, hip, and sometimes the forearm, which are prone to fracture.
After the test, your BMD results will be compared to both the average bone density of other people with the same age, sex, and race, and that of young, healthy people. If your BMD is below a certain level, you will be diagnosed with osteoporosis.
The higher your bone mineral content, the denser your bones are. And the denser your bones, the stronger they generally are and the less likely they are to break.
Osteoporosis and Osteopenia
One in three adults over 50, who have not yet developed osteoporosis, show signs of reduced bone density. This condition is known as osteopenia. An early indicator of osteoporosis, osteopenia can progress into full-blown osteoporosis without treatment. Diagnosis, risk factors, and prevention strategies are similar to those of osteoporosis.
Management Strategies for Bone Health
A combination of lifestyle changes and medications can be used to manage osteoporosis. Your healthcare provider can help identify the best options for you, looking at your age, sex, overall health, risk factors, and amount of bone loss. The highest priority is preventing future bone fractures.
Common osteoporosis treatments and strategies can include:
- Exercise: Regular exercise can help strengthen your bones and connective tissues, including muscles, tendons, and ligaments. Your healthcare provider may recommend weight-bearing exercises to build muscle strength and improve your balance. Activities that engage your body against gravity, such as walking, yoga, Pilates, and tai chi, can enhance both strength and balance while minimizing stress on your bones. You may also work with a physical therapist to find exercises and movements that are tailored to your needs.
- Vitamin and mineral supplements: Calcium and vitamin D are essential nutrients for preventing osteoporosis and supporting the development of strong bones. When you don’t get enough calcium from your diet, your body begins to draw it from your bones, which can lead to bone loss. Over time, this can cause bones to become weak and thin, increasing the risk of osteoporosis. You may need calcium or vitamin D supplements, either over-the-counter or prescription, to meet your needs. Your healthcare provider will advise you on the right type, dosage, and frequency of these supplements.
- Medications for osteoporosis:
- Bisphosphonates: For women at increased risk of broken bones, the most widely prescribed osteoporosis medications are bisphosphonates. This type of drug works by slowing down bone loss.
- Parathyroid hormone (PTH) analogs, denosumab, and romosozumab: These are forms of human parathyroid hormone that can increase bone density. They are FDA-approved for postmenopausal women with osteoporosis who are at high risk for fracture.
Both bisphosphonates and denosumab have the same rare complication of causing breaks or cracks in the middle of the thighbone and osteonecrosis of the jaw, which is delayed healing after a fracture.
- Hormone therapy: Estrogen and combined estrogen and progestin (hormone therapy) are approved to prevent osteoporosis and fractures in postmenopausal women. Estrogen, especially when started soon after menopause, can help maintain bone density. Because estrogen therapy can increase the risk of breast cancer and blood clots, which can cause strokes, it is typically used for bone health in younger women or in women whose menopausal symptoms also require treatment.
If you are prescribed medication for osteoporosis, it is still important that you get the recommended amounts of essential minerals. Also, exercising and maintaining other aspects of a healthy lifestyle remain important.
Prevention
It is important to remember that anyone can develop osteoporosis. If you are at average risk, preventing osteoporosis can be as easy as getting regular exercise, engaging in healthy diet and lifestyle choices, and ensuring you get enough calcium and vitamin D.
There are some groups of people who are more likely to experience osteoporosis and should consult with a doctor about lowering their risk, including:
- Anyone over 50.
- Women in postmenopause.
- People with a family history.
- People who are naturally thin or who have “smaller frames,” because they often have less natural bone mass, and can be affected more by any bone loss.
- People who smoke or use tobacco products.
- People with health conditions that include endocrine disorders, gastrointestinal diseases, autoimmune disorders, and blood disorders.
- People who take medications such as diuretics, corticosteroids, seizure medicines, anticoagulants, proton pump inhibitors, and those who have had bariatric surgery.
- People who regularly drink more than two alcoholic drinks per day.
Additionally, to prevent the risk of an injury related to osteoporosis, you should follow these general safety tips:
- When riding in vehicles, wear your seatbelt.
- For activities and sports, wear the right protective equipment.
- Remove clutter in your home and workspace to prevent trips and falls.
- Do not stand on tables, chairs, or countertops to reach items. Use the proper tools or equipment.
- If you have difficulty walking, use a walker or cane.
Our Approach to Osteoporosis Management
Perimenopausal or post-menopausal women are at increased risk for osteoporosis and may experience symptoms that seem related, such as bone and joint pain, as a result of decreased estrogen production. Additionally, many of the recommended diet and lifestyle choices and treatments for menopause symptoms can also help reduce some of the risks of osteoporosis or help you more effectively manage that condition.
Due to this overlap, your Advantia Health provider can work with you to understand your risks and develop a personalized treatment plan that includes referrals for additional testing or treatment based on your risk factors, personal medical history, and current symptoms.
Expert Guidance to Osteoporosis Management
The consensus from the National Osteoporosis Foundation and leading health organizations is that healthy diet and lifestyle choices are essential for both preventing osteoporosis or delaying its onset and managing the condition. Consuming enough dietary calcium and vitamin D, exercising regularly, avoiding smoking and excess alcohol, and creating a safe environment to reduce injury risk are shared recommendations.
Those at higher risk or with an osteoporosis diagnosis should discuss medication options with their provider to follow established testing recommendations and best-practice treatment guidelines.
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