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Osteoporosis Osteoporosis is a bone disease in which bones become thinner and more porous. It is usually a painless disease until a bone breaks or fractures. Fractures are the most common result of osteoporosis. More than 1.5 million osteoporosis-related fractures occur each year in the United States, mostly in older women. These fractures are usually in the spine, hip and wrist. Two thirds of women who suffer osteoporosis-related fractures are never able to live independently. One third die of complications. Although not all causes of osteoporosis are known, loss of estrogen, due to menopause, is a known factor for women. Osteoporosis is most common in older women. About 25% of women older than 60 years have osteoporosis. Women who either have had early menopause or their ovaries surgically removed before age 45, without receiving estrogen treatment, also are more likely to develop osteoporosis. Other factors that make you likely to get osteoporosis include small body frame, excessive use of alcohol, smoking cigarettes, and doing excessively strenuous exercise that stops menstrual periods. Additional factors known to cause or lead to osteoporosis include:
Aging is another factor in the cause of osteoporosis. Without treatment, men and women lose one to three percent of their bone mass each year after age 50. As life expectancies increase, osteoporosis may become even more prevalent unless preventive measures are taken. Men do get osteoporosis, but much less commonly than women. The cause of osteoporosis in men is often chronic alcoholism. Loss of testosterone (a male hormone similar to estrogen in women) is another cause. Bone Density Testing Bone density testing is used to diagnose osteoporosis. X-rays are used to rule out other bone or arthritic conditions. Thin bones may be detected on an X-ray, but bone density testing is more accurate. A bone density test measures bone mineral content. The greater the bone mineral content, the stronger or more dense the bone is. If you have a low bone density, you may be at risk for fractures in the future. The test also can be used to show rate of bone mineral loss in those not receiving treatment, and rate of bone gain in those being treated. The most common bone density test (also considered to be the most accurate) is a DEXA (dual energy X-ray absortiometry) test. This painless test is similar to having an X-ray. A miniature X-ray of the spine or hip is done along with measuring bone mineral content. A person may have osteoporosis if the amount of bone mineral content is below normal. People who are at risk of osteoporosis, as well as those who have thin bones or evidence of spinal fractures, should be tested for osteoporosis. Your healthcare provider may recommend that you be tested for osteoporosis, but if not, and you feel you are at risk, ask that you be tested. Some insurance plans may cover the cost of bone density testing. Ask your healthcare provider or medical center about this. You can do several things to maintain strong bones and prevent osteoporosis. You can help prevent osteoporosis by:
Exercise Doing weight-bearing exercise daily helps reduce bone mineral loss, as well as maintains good muscle tone and heart function. Walking or jogging one to two miles a day are ideal; playing tennis and cross country skiing are also good. Swimming, although excellent exercise, is not weight-bearing, so its benefit for bones is minimal. Ask your healthcare provider if you may begin an exercise program. Nutrition The mineral calcium, along with vitamin D, is needed for healthy bones. Taking the recommended amounts of calcium and vitamin D is important for people of all ages as peak bone mass is reached during the late 20's and into the 30's. Most adults need 1,000 to 1500 mg of calcium and at least 400 units of vitamin D each day. Four to five 8-ounce glasses of milk (vitamin D fortified) provide these requirements. The main source of vitamin D is sunlight, but it is also found in some foods or in vitamin supplements. Eating a balanced diet of nutritious food is important in maintaining an appropriate weight, which is another way to help prevent osteoporosis. Tobacco and alcohol Tobacco and alcohol use also increases your risk of developing osteoporosis. Do not use any type of tobacco ais limited to care during terminal illness or permanent unconsciousness. a durable power of attorney for health care can be applicable during temporary disability. Physical examinations See your healthcare provider for general physical examinations regularly, especially after age 50. Talk with him or her about your risk for osteoporosis and the need for bone density testing. Although there is no cure for osteoporosis, there are several medications that slow, and sometimes stop, bone mineral loss. Estrogen -- Estrogen treatment is considered to be the most effective way to regain lost bone mineral and prevent fractures. Women who are past menopause, no matter what their age, may be candidates for estrogen treatment. Use of estrogen strengthens the spine and reduces the number of fractures in the spine and the rest of the skeleton. In addition to preventing fractures, taking estrogen reduces the risk of developing heart disease, as well as having a stroke. Discuss the risks and benefits of using estrogen with your healthcare provider. Calcium supplements Regardless of the choice of drug treatment, you should take 1,500 mg of calcium and 400 units of vitamin D daily. The preferred source of calcium is from food. However, if you are unable to consume an adequate amount of calcium-rich foods, you may need to take a supplement (if you have difficulty digesting milk, for example). Supplements are just as effective as calcium-rich foods, and are absorbed just as well if taken with food. For More Information For additional information on osteoporosis, estrogen replacement therapy and/or menopause, visit the Healthworks web site on menopause called Weathering The Change.
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