Osteoporosis is not an inevitable condition caused by menopause. It is a fully preventable and treatable disease characterized by weak and brittle bones. Osteoporosis causes bones to progressively become thinner and more brittle. If left untreated, osteoporosis can continue until bones break and may lead to permanent disability.

Breaking a bone is more serious when you're older.  Mortality rates associated with hip fractures are the same as those of breast cancer in the elderly.  Hip fractures are serious among the older population.  They often require hospitalization and victims can become dependent upon a caregiver for the rest of their lives.

0.1. What causes osteoporosis?

As we grow older, it is normal for bone density to deteriorate (usually at a rate of 0.4% per year after the age of 30). Menopause slows down the production of the important bone loss protector, estrogen. Your bones begin to break down faster than they are being constructed at this time.

If your peak bone density was not reached when you were a child or a teenager, you are more likely to have osteoporosis as an adult.  Genetics, health, diet and exercise are all factors of your peak bone density.  Your bones cannot build to their ideal thickness if your diet does not have enough calcium, vitamin D and phosphorous.

0.2. Osteoporosis fast facts

• Women develop osteoporosis 4 times more frequently than men.
• People most likely to contract the disease are of European and Asian ancestry.
• People of African ancestry are the least likely to have osteoporosis.
• Ten million Americans have osteoporosis (8 million women).
• Thirty-four million Americans are at-risk by having low bone mass.
• One in two women over age fifty will have an osteoporosis-related fracture in her remaining lifetime.
• Osteoporosis is responsible for more than 1.5 million fractures annually:
  • 300,000 hip fractures
  • 700,000 vertebral fractures
  • 250,000 wrist fractures
  • 300,000 other fractures
• Women can lose up to 20 percent of their bone mass in the five to seven years following menopause.
• As many as 95% of adults who break a bone are being treated without being evaluated for osteoporosis.

0.3. Osteoporosis Symptoms

Osteoporosis is a silent disease because there are very few obvious symptoms. The condition slowly progresses over time. Many people do not realize they have osteoporosis until they have a minor injury that breaks a bone.

Are you shrinking as you age?  Well, you're probably not losing height. Your posture is being compromised because you may be stooping over.  The bones in your spine are compressing because they are no longer strong enough to support its lovely curve.

Every bone in your body can be affected by osteoporosis as they become brittle and more susceptible to breaking. With time, your body's strength is lost and you can fall easier, placing you at greater risk for fracture.

Talk to your doctor about your bone health as you grow older. Tell your doctor if you are taking (or have taken) steroids, thyroid supplements, antacids, seizure medications, diuretics or inhalers for any length of time as they can affect bone health.

0.4. Who is at risk for osteoporosis?

• People age 65 and up
• Individuals who have broken a bone after age 50
• Individuals with relatives who have a history of low bone mineral density or osteoporosis
• People with fair to poor health
• Smokers
• People who are underweight for their height
• If you started menopause before age 45
• If you didn't receive enough calcium before age 30
• Those people with a sedentary lifestyle

You are more susceptible to osteoporosis if you have one of these medical conditions:

Other people at risk are those taking the following medications:

0.5. Preventing Osteoporosis

You can't stop your bones from losing their mass as you age. It is a natural process. The thickness of your bones early in life can help you prevent osteoporosis. The thicker your bones are, the less likely they are to break, the less likely you are to contract osteoporosis.

There are certain things that are out of your control. There is nothing you can do about your genes. If your mother had osteoporosis, you are likely to have below-average bone density. Petite women usually have lower bone density and greater bone loss. Caucasian and Asian women are more likely to get the disease.

There are certain things that you can control to prevent osteoporosis. One of the most important prevention steps is building up your bone density as much as possible until it is too late (at around age 30). Listen to your parents- drink your milk so you can have healthy bones!!

You can make certain lifestyle decisions to prevent osteoporosis also. We all know tobacco, smoking, consuming an abundance of caffeine and drinking excessively are horrible for your health but did you know they also decrease bone density?  You have control over these habits.

Exercise, exercise, exercise. We hear it all the time. One more benefit to being physically active is to release your stress from your mind and exert it on your bones. They actually need the stress to gain their strength. It forces your bones to absorb calcium and stimulates the muscles around the bones. A sedentary lifestyle is damaging to your health in many ways. You can reduce your risk of fracture up to 30% if you exercise.

Bones need calcium. You can control your intake of calcium through your diet. Menopausal women are recommended to take in 1,200 milligrams of calcium every day after age 50.  This is a lot of calcium!

Can you get that much from your foods?  Many women find they can't, so they take supplements. In order to absorb this calcium, your body also needs vitamin D.

Adjust your diet to maximize the amount of calcium you intake through foods. The food group with the most calcium is the milk, yogurt and cheese group.  Some other foods that are high in calcium include:

• Black beans
• Navy beans
• Fortified cereal
• Soybeans
• Spinach
• Bok choy
• Kale
• Fortified orange juice
• Soy milk
• Tofu
• Almonds
• Oysters
• Broccoli
• Turnips

0.6. Testing for Osteoporosis

A Bone Mineral Density Test (BMDs)is really the only way to determine whether you are at risk of fracture from osteoporosis. Your bone mineral density test readings are compared to standards that match your age, sex and size. Test results are the best way to determine if you have osteoporosis and plan the future of your bone health.

Red Hot Mamas recommends BMD testing for the following people

• Postmenopausal women with medical causes of bone loss, regardless of age
• Postmenopausal women of at least the age of 65 regardless of risk factors
• For women younger than 65 years old, we recommend testing for anyone with one or more of the following risk factors for fracture:
  • Fracture after menopause (other than the skull, facial bone, ankle, finger and toe)
  • Thinness
  • History of hip fracture in a parent
  • Current smoker

0.7. Osteoporosis Treatments

Various treatments are on the market to preserve and increase bone density. When used in conjunction with exercise and a healthy diet, the following drugs can increase bone density over time. In fact, they are frequently used as osteoporosis treatments.

Two forms of drugs are available to improve bone density. The first group of drugs that are available are called anti-resorption drugs. This treatment slows down the rate of bone loss. Anti-resorption drugs include the following:

• Bisphosphonates: This bone-specific drug decreases bone loss, preserve bone density and strength and reduces risk of fractures.In order for the body to fully absorb this drug, it must be taken on an empty stomach with water only and at least 30 minutes prior to eating, drinking or taking other medications.
• Raloxifene: This treatment is in a class of drugs called SERMs (selective estrogen receptor modulators). Raloxifene is approved in both Canada and the US for treating osteoporosis. In some parts of the body, SERMs act like the hormone estrogen while in other parts of the body, they block the effects of estrogen. Unlike estrogen therapy, Raloxifene does not help with short-term menopause symptoms (i.e., hot flashes).
• Estrogen Therapy: This therapy is usually used for preventing osteoporosis, not treating it. Studies have shown ET increases bone mass and decrease the risk for fractures of the spine and hip. Other benefits of ET include relief for menopause symptoms. The risks of ET are discussed in our hormone therapy section.
• Calcitonin: This is a type of hormone treatment that is available as a nasal spray or as an injection. It is approved in Canada and by the FDA for the treatment (not the prevention) of osteoporosis in women at least 5 years past menopause. It increases bone density but studies have shown it is less than the gain of estrogen or biphosphonates.

The second group of bone density drug treatments is bone forming drugs that promote bone formation through parathyroid hormone (PTH). This is the latest osteoporosis treatment approved by the FDA. It is still waiting approval in Canada. PTH is the first type of drug that actually stimulates new bone growth. The downside to the treatment is it requires daily injections.

View a complete list of government-approved osteoporosis drugs available in the US and Canada. Alternative therapies are sometimes prescribed by medical practitioners for preventing bone loss but are not currently FDA-approved for this. Phytoestrogens and other new therapies are currently being tested for this use.