Osteoporosis is a health condition that weakens your bones, making them weaker and more brittle. They become so brittle that even a tiny fall or stumble can result in a fracture or break. The condition develops over several years and often goes unnoticed by those who have it until they experience a fracture.

Most people diagnosed with osteoporosis develop it later in life and it occurs more often in women than it does in men. However, this doesn’t mean that only older women get osteoporosis.

Osteoporosis Risks

• Age: After the age of 30, you’ll start to lose bone mass and density. This makes you more likely to develop osteoporosis, especially if you don’t get enough calcium and vitamin D into your diet. You should also regularly do strength training and weight-bearing exercises to strengthen your bones. Your risk increases as you age.
• Menopause: When women go through the menopause, they stop producing as much of a hormone called oestrogen. Oestrogen helps with bone strength so after the menopause, so postmenopausal women are more likely to develop osteoporosis.
• Hormonal changes: In addition to the menopause, cancer treatments that reduce oestrogen and testosterone levels can make bones weaker.
• Gender: While osteoporosis is 4 times as likely in women than in men, people of all genders are susceptible to osteoporosis. Women are more at risk than men because they tend to have lighter and thinner bones and a longer lifespan.
• Ethnicity: Caucasian and Asian women have higher rates of osteoporosis than other ethnicities.
• Bone Structure: Petite women or people with a smaller stature tend to have weaker bones so they have less bone to lose after the age of 30. This increases their risk of osteoporosis.
• Genetics: People with a family history of osteoporosis are more likely to develop it themselves. You should take extra steps to protect yourself if you have parents or grandparents with osteoporosis or a history of features like hip fractures.
• Weight and Nutrition: People who are consistently underweight have the same risks as those with a petite frame because they don’t have as much bone mass. Those with eating disorders or who have poor diets are also at an increased risk due to malnutrition.

Other factors that can contribute to osteoporosis include glandular problems and gastrointestinal surgery. If your thyroid gland or any other glands are overacting, it can contribute to more rapid bone loss. Gastrointestinal surgery, especially those used for weight loss, prevents your body from absorbing as many nutrients including calcium and vitamin D.

Osteoporosis vs Osteopenia

Osteoporosis and osteopenia are both conditions that affect bone and health strength but are different conditions. Osteopenia is often considered the first step toward developing osteoporosis. When you have osteopenia, you have a lower bone density than you should, but you aren’t at the point yet where you’re at risk of fractures. You can still take steps to prevent osteoporosis from developing when you have osteopenia.

Your bone strength and density are measured with bone mineral density scores (BMD scores). The lower your score, the more likely you’ll get osteopenia and/or osteoporosis. If your score is lower than it should be for your circumstances, between -1 and -2.5, you may be diagnosed with osteopenia. Scores lower than -2.5 indicate osteoporosis.

Osteoporosis is a more serious evolution of osteopenia. With osteoporosis, the honeycomb-like structure inside your bones becomes more porous. This leaves more open spaces inside your bones, reducing their density and strength. This is what makes you more likely to experience fractures and other symptoms of osteoporosis.

Osteoporosis Side Effects

At first, you may not know you have osteoporosis because you aren’t experiencing any noticeable symptoms. It isn’t uncommon to only realise you have it until you either have a bone fracture or get a bone density scan.

There usually aren’t any symptoms in the early stages, but as the bones get weaker you may experience:

• Gradual loss of height
• Back pain caused by problems with your vertebrae
• A hunched or stooped posture
• Bones that fracture or break much easier than they should

As the disease progresses, you’re more at risk of serious bone fractures in the spine and hip. Hip fractures are usually caused by a fall and may leave a person permanently disabled or with limited mobility. The mortality rate for these patients is also higher than it would be without a hip fracture.

Spinal fractures can be caused by a fall, but can also happen with no obvious injury. Over time, the vertebrae can weaken so much that they collapse, causing symptoms like back pain, a stooped posture, and loss of height.

Osteoporosis Treatment

If you’re diagnosed with osteoporosis, your treatment will be determined based on your risk of fracture. This is usually done by analysing information like the results of your bone density test. Patients who are considered low-risk may only need to make lifestyle changes to improve their bone health.

Higher-risk cases may need to make lifestyle changes alongside medical treatment. One of the most commonly prescribed medications for men and women with osteoporosis are bisphosphonates like Ibandronate (Bonviva) and Alendronate (Fosamax).

Bisphosphonates work by slowing down the cells that break down bone. This slows down the progression of bone loss, allowing your bones to regenerate without as much loss. This also makes them stronger in the long run, reducing your risk of fracture.

You should have increased bone density after about 6-12 months of taking a bisphosphonate. The average length of treatment is 3-5 years, but you’ll need to have regular check-ins with your healthcare provider to ensure they are still working for you. Once you stop taking them, you should still have a few years of protection.

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