Almost 20 million American women, or nearly half of those past menopause, have thinning bones and don't know it, one of the largest osteoporosis studies to date suggests.
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December 12, 2001
By Alice Chang, M.D.
Harvard Medical School
How does this article relate to me?
This article demonstrated that bone loss and osteoporosis are far more common than we think. This study also found that even when someone has had a fracture, the diagnosis may still not be made. But who should get screened is still the question. Bone-density scans, the gold standard, are expensive. This study used a less expensive machine that looked at the heel, forearm or finger, whereas standard scans look at the spine and hip. This study may help us use a more accessible screening tool to predict who is likely to have a fracture.
Before you run out to check if you have this silent disease, remember that the impact is greatest at the time of menopause. Ultimately, the reason to be aggressive about diagnosing and treating osteoporosis is to prevent hip fractures, which are associated with a high mortality rate in the first year after the fracture. In general, recovery from any osteoporosis-related fracture can be painful and take weeks to months of therapy to return to normal function.
What changes do I need to make?
If you are in perimenopause or menopause, especially if you are making decisions about hormone-replacement therapy, assess your osteoporosis risk and talk to your doctor about taking a bone-density test. If you already are showing bone loss, you should consider hormone-replacement therapy or nonhormonal treatments to prevent further bone loss. Keep in mind that the greatest degree of bone loss occurs at the beginning of menopause.
Risk factors for osteoporosis include:
- Reaching menopause, especially early or early surgical menopause
- Using tobacco
- Having a family history of osteoporosis or fractures at an older age
- Using corticosteroid medications
- Being Caucasian or Asian
- Being thin
- Using alcohol to excess
- Having hyperthyroidism
- Losing height
Standard recommendations for preventing osteoporosis include getting enough calcium (1,000 to 1,500 milligrams a day) and vitamin D (400 international units a day) and engaging in any weight-bearing exercise (walking, aerobics, jogging and running are preferred over bicycling or swimming). Exercise and sufficient vitamin D actually may be more important in preserving bone mass and preventing fractures. Elderly people are commonly vitamin D deficient, and just the addition of 800 international units of vitamin D daily has been shown to be quite effective.
If you have had a fracture in your post-menopausal years, you should see your doctor for a bone-density test if you haven't already had one.
What can I expect in the future?
Studies that can better define who is at risk for osteoporosis and what factors increase the risk will help guide better screening recommendations. We also need to better diagnose and treat people who have already had wrist or spine fractures in order to prevent hip fractures.
Related Areas:
Osteoporosis
