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The Silent Killer: Osteoporosis - Are You at Risk?

by Betty Soldz

"There are many options available to women today concerning the prevention of Osteoporosis.  Women need to take charge of their long-term health by understanding their risk for osteoporosis and what to do to prevent it." 

Deborah Ortiz (California State Senator)

Osteoporosis is primarily a woman's disease.  Fully eighty percent of the 25 million Americans that have this disease are women. Over half of all women over age 50 will break a bone sometime in their life, due to this disease. 

Osteoporosis means 'porous bones.'  It thins and weakens bones so that they easily break - especially bones in the hip, spine, and wrist.  A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.   This disease is called the "silent killer" because you may not notice any symptoms until you fracture a bone. Stresses to your body such as coughing or lifting something heavy or even bending down to pick up your newspaper can cause such a fracture.  Although Osteoporosis can strike at any age your risk increases as you age.

It does not need to be a consequence of growing older, however.  It is largely a preventable and treatable disease, although there is no known cure.  It is never too late for a woman to take some action and for those women who haven't reached menopause as yet, it can be prevented.   If you are beyond menopause, early detection and a course of action can halt its progress and even rebuild some bone. Some of the risk factors for Osteoporosis are:

  •  Early menopause which would begin before age 40. 
  •  After menopause, due to a decrease in estrogen which is a hormone that appears to protect against bone loss.
  •  White and Asian women are the most likely to get osteoporosis.
  •  If you have relatives with a history of fractures.
  •  If you are small boned or thin, you are at greater risk.
  •  Taking certain medications such as cortisone-like drugs, heparin, seizure medications as well as others.
  •   Lifestyle such as smoking, drinking too much, taking too little calcium and doing little or no weight bearing exercise.

According to the National Osteoporosis Association there are four important steps that can be taken to prevent this disease. 

  •   A balanced diet rich in calcium and vitamin D
  •  Weight bearing exercise
  •  Avoid smoking and limit excessive use of alcohol
  •  Bone Density testing and medication when appropriate

An inadequate intake of calcium is thought to contribute to the development of Osteoporosis.  If you do not eat enough food rich in calcium and vitamin D on a daily basis, you might consider a calcium supplement.  National surveys have found that most women (and even children) consume less than one-half the recommended 1000 to 1300 mg a day of calcium recommended to maintain healthy bones. Vitamin D helps in the absorption of calcium by your body and calcium supplements can be purchased  with the addition of Vitamin D. 

Exercise builds bone strength and helps prevent bone loss.  Weight bearing exercise includes such activities as walking, jogging and playing tennis.  It is prudent to check with your doctor before starting an exercise program.
Women's health organizations, such as 50 + and Strong suggest that all women 50 and over have a Bone Mineral Density test (BMD) in order to establish a base line for bone loss as we get age.  Some states have passed laws making it mandatory for insurance companies to pay for bone density tests for women at risk. Losing height or breaking a bone may be the first sign of Osteoporosis. It is best to discuss this disease, its prevention and treatment with your doctor before this happens. A BMD test can help determine whether you need medication to maintain bone mass, prevent further bone loss, and reduce your fracture risk. The test is painless and noninvasive. Medicare now covers BMD tests for those at risk.

Until recently there weren't any medications to help stop bone loss and rebuild bone except estrogen.   Fortunately there are now a variety of options for prevention and treatment. The following are some of them, however not every drug is right for every woman.

You have probably heard that estrogen replacement therapy (ERT) may prevent osteoporosis and also be beneficial in preventing some cancers, heart disease and stroke.  There are however, certain risks involved in ERT and it is not appropriate for all women.  Another prescription medicine approved by the FDA is alendronate (marketed as Fosamax). In large enough doses it is suppose to increase bone density and decrease the risk of spine hip fractures.  Calcitonin is a naturally occurring hormone that has been shown to  increase bone density in the spine and also reduce pain of fractures.  The newest treatment for Osteoporosis is selective estrogen receptor modulators (SERMS) marketed as Evista. According to the manufacturers literature, "Evista helps prevent Osteoporosis by building bone and stopping the thinning of bone that occurs after menopause...It also treats osteoporosis by helping make bones stronger and less likely to break."  Learning  more about these options and discussing benefits, risks and possible side affects with your doctor will help you to find the best way to lower your risk for this debilitating condition.

If you have Osteoporosis,  preventing falls is important to protect you against fracturing a bone. The following is a safety checklist of a few items you might want to consider to avoid falling and perhaps fracturing a bone:

  •  Make sure all carpets are anchored and skid-proof.
  •  Remove all loose wire and electric cords from the floor
  •  Avoid using slippery wax on your floors.
  •  Be sure handrails are sturdy and stairs are well lit
  •  Install night lights
  •  Install grab bars near toilets and tubs
  •  Make sure your nightgown and dresses are short enough to avoid tripping on them

The best way to prevent Osteoporosis is to be proactive in one's own healthcare.  Don't wait to protect your bones.  Taking action now by living a healthy lifestyle, talking to your doctor and having a BMD test may help to insure you a long, healthy life free from this disease.

If you have any questions, please contact me by e-mail at



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