Conditions We Treat

Osteoporosis is a silent skeletal disorder that results from a loss of bone mass, which affects men and women. The change in the structure of bones causes weakness and results in an increased risk of fracture. The most common fractures occur in the spine, wrist, and hip. Spine and hip fractures, in particular, may lead to chronic (long-term) pain, disability, and even death. Fortunately, you can take steps to reduce your risk of osteoporosis and avoid the often-disabling broken bones (fractures) that can result from this condition. If you already have osteoporosis, new medications are available to slow or even stop the bones from getting weaker. These medicines also can decrease the chance of having a fracture.

What causes osteoporosis?

Osteoporosis results from a loss of bone mass (measured as bone density) and a change in bone structure. Many factors raise the risk of developing osteoporosis and breaking a bone. You can change some of these risk factors but not others. Recognizing your risk factors is important so you can take steps to prevent this condition or treat it before it becomes worse.

Major risk factors that you cannot change include:

• Older age (starting in the mid-30s but more likely with advancing age)
• Non-Hispanic white or Asian ethnic background
• Small bone structure
• Family history of osteoporosis or an osteoporosis-related fracture in a parent or sibling
• Prior fracture due to a low-level injury, particularly after age 50

Risk factors that you may be able to change include:

• Low levels of sex hormones, mainly estrogen, in women (e.g., menopause)
• The eating disorders anorexia nervosa and bulimia
• Cigarette smoking
• Alcohol abuse
• Low calcium and vitamin D, from low intake in your diet or inadequate absorption in your gut
• Sedentary (inactive) lifestyle or immobility
• Certain medications, including the following:
• Glucocorticoid medications (also called corticosteroids), such as prednisone (brand names: Deltasone, Orasone, etc.) or prednisolone (Prelone)
• Excess thyroid hormone replacement in those taking medications for low thyroid or hypothyroidism
• Heparin, a commonly used blood thinner
• Some treatments that deplete sex hormones, such as anastrozole (Arimidex) and letrozole (Femara) to treat breast cancer or leuprorelin (Lupron) to treat prostate cancer and other health problems
• Diseases that can affect bones
• Endocrine (hormone) diseases (hyperthyroidism, hyperparathyroidism, Cushing’s disease, etc.)
• Inflammatory arthritis (rheumatoid arthritis, ankylosing spondylitis, etc.)

What Is Osteoporosis?

Osteoporosis is more common in older women, mainly non-Hispanic white and Asian women. Yet it can occur at any age, in men, women, and in all ethnic groups. People over age 50 are at the greatest risk of developing osteoporosis and having related fractures. Over age 50, one in two women and one in six men will suffer an osteoporosis-related fracture at some point in their lives. In the U.S., about 4.5 million women and 0.8 million men over the age of 50 have osteoporosis, according to 2005–06 data. These figures are lower than older estimates, suggesting that osteoporosis is decreasing in the population. This is consistent with recent trends seen as decreasing.

However, another 22.7 million women and 11.8 million men over age 50 have low bone mass (known as osteopenia). People with low bone mass are also at higher risk of fractures, but it is not as high as for people with osteoporosis. If bone loss continues, people with osteopenia can become osteoporotic.

How is osteoporosis diagnosed?

You can learn if you have osteoporosis by having a simple test that measures bone mineral density—sometimes called BMD. Dual-energy X-ray absorptiometry (DEXA) is the current best test for measuring BMD.

The test is quick and painless. It is similar to an X-ray but uses much less radiation. Even so, pregnant women should not have this test to avoid any risk of harming the fetus. DXA test results are scored compared with the BMD of young, healthy people.