Osteoporosis means porous bone. It is a disease in which bone density is reduced, causing bones to thin, weaken and become brittle. This, in turn, greatly increases the risk of bones breaking. The bones most often affected by osteoporosis are the hips, spine and wrists.
The bone loss that occurs as part of osteoporosis is progressive (it continues over time), and there often are no symptoms until a bone breaks.
Osteoporosis and low bone mass (a condition called osteopenia) are a major public health problem for an estimated 44 million U.S. women and men aged 50 and older. This represents 55 percent of Americans in this age group.
Of the approximately 10 million Americans who currently have osteoporosis, 80% are women. Women are more likely to get this disease because estrogen, a hormone in women that protects bones, drops sharply when women reach menopause, so bone loss speeds up. Also, women tend to have smaller, thinner bones than men to begin with.
As a result, about one in two women over age 50 will break a bone due to osteoporosis. In fact, a woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer.
Other factors that can contribute to developing osteoporosis are a lack of dietary calcium and vitamin D, a sedentary lifestyle, thyroid and other medical conditions, smoking and chronic alcohol use.
The good news is that many of these are lifestyle-related factors that people can control to reduce the risk of developing osteoporosis. There also are several medications available for treating osteoporosis that can help to rebuild and strengthen bone and reduce fracture risk.
Because osteoporosis can develop without symptoms, it’s important to be screened. Experts recommend that you have a bone density test (called a DEXA scan) if you are a woman age 65 or older, a postmenopausal woman under age 65 with risk factors, or a man age 50 to 69 with risk factors.
Why Choose Cooper to Diagnose and Treat Osteoporosis
Cooper University Health Care has a skilled team of board-certified specialists with extensive expertise in diagnosing and treating osteoporosis. You can count on us for:
- DEXA scan expertise: Cooper performs over 2,000 DEXA scans a year—more than any other facility in the region, reflecting the depth of our experience in diagnosing osteoporosis. Importantly, all scans are read by a fellowship-trained rheumatologist.
- Treatment tailored to your unique needs: From nutritional counseling, guidance on lifestyle changes, exercise and fall prevention, to careful medication management and ongoing monitoring, we provide a full range of care that’s personalized for your individual needs
- Multidisciplinary clinical resources: As the region’s only academic health system, Cooper has experts in more than 75 specialties, giving you access to all the expertise you need, all in one place
- We work closely with your primary care physician, who generally will manage your osteoporosis on an ongoing basis.
Causes and Risk Factors for Osteoporosis
The main cause of osteoporosis is a low level of hormones, particularly estrogen in women and testosterone in men. Postmenopausal women are frequently diagnosed with osteoporosis because menopause is accompanied by a sharp drop in estrogen levels.
A number of other factors increase the likelihood of developing osteoporosis, including:
- Aging: Bones become less dense and weaker as we age
- Gender: Women are four times as likely to develop osteoporosis as men
- Race: Caucasian (white) women of European descent and Asian women are most at risk, but all races are susceptible to the disease
- Body weight: Having a lower body weight and less muscle increases the risk of osteoporosis
- Having osteopenia: Osteopenia is a condition in which your bones are weaker and less dense than normal, but they aren’t so brittle that they break easily, as in osteoporosis. Having osteopenia increases your risk of developing osteoporosis.
- Sedentary lifestyle: Lack of physical activity contributes to lower bone density
- Dietary factors: Caffeine use, excessive alcohol use and a lifetime lack of dietary calcium all increase the risk of developing brittle bones. Eating disorders in which food intake is severely restricted can also weaken bones.
- Vitamin D deficiency: Lack of adequate vitamin D, either through diet or sun exposure, contributes to osteoporosis risk
- Smoking: Tobacco use contributes to lower bone density
- Certain medicines: Taking synthetic glucocorticoids (such as prednisone), proton pump inhibitors (PPIs) for treating acid reflux, certain cancer treatment drugs, excessive thyroid hormone replacement, diuretics and other medications can affect bone density.
- Family history: If a parent or sibling has been diagnosed with osteoporosis, you are more likely to develop the disease
- Other medical conditions: Osteoporosis risk is higher in people with certain medical conditions including kidney or liver disease, lupus, cancer, celiac disease, inflammatory bowel disease and rheumatoid arthritis
Symptoms of Osteoporosis
Many people with osteoporosis have no symptoms of the disease until they experience a bone fracture. Often, the bone breaks much more easily than expected. Other people may exhibit such symptoms as:
- Pain in the bones and muscles, especially the back
- A collapsed vertebra, which can cause severe pain
- Shrinking in height over time
- Kyphosis (also called dowager’s hump), a rounding of the upper back
Treatment of osteoporosis is tailored to your age, overall health, the severity of your disease, and how well you can handle specific medicines or therapies. The goal of treatment is to decrease pain, prevent fractures and minimize further bone loss.
Medication is a mainstay of treating most cases of osteoporosis. Today there are several types of medications that have been shown to rebuild and strengthen bone, helping to reduce the risk of fracture. These include:
- Bisphosphonates: These are the most widely prescribed medications to help reduce bone loss and increase bone density. They may be taken as a weekly or monthly pill or given via a quarterly or yearly injection.
- Monoclonal antibody: This type of medicine is given by injection under the skin every 6 months
- Hormone replacement therapy: While estrogen can help maintain bone density when given right after menopause, it can also increase the risk of blood clots, certain types of cancer and perhaps heart disease. It’s typically used to maintain bone health in younger women or in women whose menopause symptoms also require treatment. Another hormone drug called raloxifene mimics estrogen’s beneficial effects on bone density in postmenopausal women without some (but not all) of estrogen’s risks.
- Other bone-building medications: These drugs are similar to parathyroid hormones and stimulate new bone growth. They are taken for two years, then another osteoporosis drug is recommended.
Lifestyle-related activities are also an important component of managing—and preventing—osteoporosis. These include:
- Maintaining a proper body weight
- A regimen of regular walking and other weight-bearing exercises
- Cutting down on caffeine and alcohol
- Quitting smoking
- Getting enough dietary calcium and vitamin D (either through supplements or sufficient sunlight exposure)
- Preventing falls by installing handrails (especially in the bathroom and shower) and nightlights, getting rid of area rugs, and using assistive devices such as a cane or grabber