osteoporosis

Osteoporosis means “porous bones” or thinning of the bones which means they become more fragile and can break more easily. Osteoporosis is usually undiagnosed until a fracture occurs, such as at the wrist, spine or hip. As we get older our bones get thinner, particularly in women after the menopause when they no longer producing oestrogen.

One in three women will develop osteoporosis and around 40% of women will suffer an osteoporotic fracture. Broken bones as a result of osteoporosis mainly affect post-menopausal women and are the largest group at risk of osteoporosis.

Not all women develop osteoporosis. The following situations are risk factors for developing bone loss and osteoporosis. If you:

Had your menopause before the age of 45

Have already had a bone fracture

Have a strong family history of osteoporosis

Have a body mass index (BMI) of 19 or less

Have a time when your periods stop for six months to a year or more before the time of your menopause

Have taken, or are taking, a steroid medicine for three months or more

Are a smoker

Have an alcohol intake of four or more units per day

Lack calcium and/or vitamin D

Have never taken regular exercise

Have, or had, certain medical conditions that can affect your bones and increase your risk of osteoporosis

There are several effective treatments which may reduce the risk of fracture:

Hormone replacement therapy (HRT) – a reduction in oestrogen which occurs following menopause is often mirrored by an increase loss of bone. HRT replaces oestrogen and reduces the rate of bone loss. HRT, if taken early in menopause and if taken for a few years is thought to be of most benefit. HRT is not recommended for a long-term prevention of osteoporosis because there are other medicines available; however it remains an option for women over 50, at risk of fractures when other medicines are not suitable. There are various types and doses of HRT available and even small doses of oestrogen have been shown to be beneficial to bones. HRT can prevent bone loss and is particularly useful around the menopause.

Selective oestrogen receptor modulator (SERM) therapy works like an oestrogen to protect bones without the effects of HRT. It can be used to both prevent and treat osteoporosis in post-menopausal women.

Bisphosphonates – this is a group of medicines which slow the rate bones dissolve thus building up bone strength. 

Calcium and vitamin D supplements can be taken with the above treatment for bone protection.

Strontium helps build up bones as well as preventing loss.

Parathyroid injections can be administered to women with severe osteoporosis who have not responded to other therapies.

Strontium ranelate (Protelos) is used for the treatment of osteoporosis in post-menopausal women. It increases bone formation and decreasing bones breaking down.  It has also reduces the risk of spine and hip fractures.

As well as effective treatments which would be prescribed by your doctor a healthy lifestyle is important for bones at any age and can help prevent osteoporosis. Stopping smoking should be a priority and alcohol intake should be kept within safe limits. Taking regular exercise is the single most important action you should take to improve the strength of your bones. The most beneficial sort of exercise to prevent osteoporosis is weight bearing exercise, such as walking or aerobics. Excessive running may cause increased bone loss. 

Calcium is important at all ages: for women after the menopause the basic daily requirement is the equivalent of a pint of milk. Calcium supplements can be bought either over the counter or if your dietary intake is low your GP may prescribe you with a calcium supplement.

It is advisable when considering embarking on a treatment regime to consult with your GP first.

Information written by the talkhealth medical panel

Last Reviewed: 14 February 2011
Next Review Date: 14 February 2013