Osteoporosis in Women: Causes, Risk Factors, Treatment

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Table of Contents

Introduction
Aims and objectives
Risk Factors for Developing Osteoporosis
Action plan
Prevention and Treatment for Osteoporosis
Conclusion
References

Introduction

Osteoporosis is commonly seen among women a decade o so after menopause. Osteoporosis results from the inadequate accumulation of bone mass during childhood and early adulthood followed by rapid resorption after menopause.

The primary treatment for this Osteoporosis inclusive consideration of underlying metabolic abnormalities and provision of supplemental calcium/Vitamin D in conjunction with bisphosphonates or calcitonin or both. It should be noted the hormone replacement therapy has been withdrawn since adverse effects were identified in long-term follow-up studies. Osteoporosis results from the loss of the normal density of bone the spine, hips, and wrists are common areas of bone fractures from Osteoporosis. The fracture can be either in the form of cracking or collapsing compression fracture of the vertebrae of the spine. Osteoporosis-related fractures also occur in almost any skeletal bone. [10]

Aims and objectives

One of the most significant health matters for middle-aged women is the threat of osteoporosis. It is a condition in which bones become thin, easily broken, and highly prone to crack. Numerous researches over the past 10 years have linked estrogen insufficiency to this gradual, yet debilitating disease. In fact, osteoporosis is more closely related to menopause than to a woman’s chronological age. [3]

Each year about 500,000 American women fracture a spine, the bones that make up the spine, and about 300,000 will fracture a huckle. Nationwide, treatment for osteoporotic fractures costs up to $10 billion per year, with hip fractures the most expensive. Vertebral fractures lead to curvature of the spine, loss of height, and pain. A severe hip fracture is painful and recovery may involve a long period of bed rest.

Nutrition is well recognized for its considerable, optimistic impact on academic presentation and students’ growth and expansion. Moreover, good nutrition and physical activity facilitate the expansion of good lifestyle habits that will add to students’ health and take advantage of achievement. Children and youth in Newfoundland and Labrador have the highest overweight and obesity rates in Canada. Harmful foods, physical immobility, and obesity are common risk factors of chronic diseases such as heart disease, stroke, diabetes, and cancer. Newfoundlanders and Labradorians undergo some of the uppermost rates of these diseases.

Children and youth are enhancing diabetes and the risk factors for heart disease and cancer at a much earlier age. Moreover to obesity and related diseases, other health concerns are related to unhealthy food habits replacing more nutritious foods. For example, soda pop is replacing milk in students’ diets and it is significant for children and teenagers to have a sufficient calcium intake to reduce the risk of fractures and osteoporosis later in life. It is important to provide nourishing foods in schools where the meals and snacks guzzled can make a major contribution to students’ and staffs’ total daily consumption of food and nutrients. [8]

Risk Factors for Developing Osteoporosis

The following factors that will increase the risk of developing Osteoporosis are

Female gender
Thin and small body frames
Family history of osteoporosis (for example if mother have osteoporotic hip fracture)
Personal history of fracture as an adult
Cigarette smoking
Excessive alcohol consumption
Lack of exercise
Diet low in calcium
Poor nutrition and poor general health
Malabsorption
Low estrogen levels (like the occurrence of menopause or with early surgical removal of both ovaries)
Chemotherapy can cause early menopause due to its toxic effects on the ovaries
Amenorrhea (loss of the menstrual period)
Vitamin D deficiency (since Vitamin D helps the body absorb calcium. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis. Vitamin D deficiency can result from lack of intestinal absorption of the vitamin such as occurs in celiac sprue

Certain medications can cause osteoporosis. These include long-term use of heparin which is blood thinner. [4]

The following class of drugs also cause bone loss

Excessive thyroid hormones
Anticonvulsants
Antacids containing aluminum
Gonadotropin-releasing hormones used for treatment of endometriosis
Methotrexate for cancer treatment
Cyclosporine A, an immunosuppressive drug
Heparin
Cholestyramine (which was taken into control blood cholesterol levels)

Women lose bone material more rapidly than men especially after menopause when the level of estrogen falls. Oestrogen is a female hormone and helps to protect against bone loss. By the age of 70, some women have lost 30% of their bone material. In the UK about half of women and about 1 in 5 men over the age of 50 will fracture a bone and many of them as a result of osteoporosis. [1]

All men and women have some risk of developing osteoporosis as they become older when they are crossing the age of 60. women are more at risk than men. The following situations also increase the risk of developing bone loss and osteoporosis.

A woman who had menopause before the age of 45
Already had a bone fracture after a minor
Strong family history of osteoporosis
Have body mass index BMI of 19 or less.
A woman who stopped period for a year more before the time of menopause.
Smoking
Lack of calcium or vitamin D i.e. due to poor diet and little exposure to sunlight.
Lack of regular exercises [10]

Action plan

The NOF recommends one hour of weight-bearing activity–for instance, brisk walking (faster than a stroll, slower than when you’re late for a meeting)–four to six days a week. This prescription doesn’t rule out non-weight-bearing activities, like swimming or yoga. Small preliminary studies looking at bicycling, underwater workouts, and t’ai chi have shown modest improvements in bone density in postmenopausal women. Working out with weights is also recommended for building muscle strength, which, in addition to benefiting bone, Dr. DiNubile says, can help absorb shock from falls.

Osteoporosis develops as a result of sub-optimal bone growth in childhood and adolescence, and/or loss of bone mass later in life. Falls also play an important role in the development of osteoporotic fractures. Preventative measures should therefore address these issues. Lifestyle adjustments include ensuring good nutrition throughout life (in particular, adequate calcium and vitamin D intake), adequate levels of physical activity, avoiding smoking, and avoiding alcohol abuse.

Although there is good evidence for the importance of calcium and vitamin D in osteoporosis prevention, there is little promotion of this at the governmental level. In addition, not every European country has defined a recommended daily intake of these nutrients. Perhaps, as a result, inadequate intake is very common (particularly in the elderly). Weight-bearing exercise early in life is known to increase peak bone mass.

Importantly for elderly individuals, as well as improving bone mineral density, exercise also increases muscle strength, thus improving coordination and helping to prevent falls. Children and adolescents have been targeted in campaigns to improve nutrition and raise levels of physical activity. High-risk groups can also be targeted in campaigns to minimize osteoporosis-related lifestyle risk factors. Better promotional and educational programs are required in order to persuade more people to make the right lifestyle choices. [14]

Step 1: Awareness-raising campaigns
Step 2: Preventive strategies: lifestyle considerations
Step 3: Guidelines for the prevention of osteoporosis-related fractures
Step 4: Fracture care, rehabilitation, and prevention of falls
Step 5: Economic data
Step 6: Evaluation of actions and planning the allocation of future healthcare resources: the European fracture database

The first issue in preventing osteoporosis is getting enough calcium, but there’s wrangling over how much is enough. The current U.S. Recommended Daily Allowance for women over twenty-five is 800 milligrams. Last June the National Institutes of Health Consensus Development Conference on Optimal Calcium Intake upped that to 1,000 milligrams for women over twenty-five and menopausal women on estrogen replacement therapy (1,500 milligrams for women not on ERT). [16]

Prevention and Treatment for Osteoporosis

Prevention of osteoporosis is an important treatment for the person. The following measures can be taken.

Calcium Supplements

Building strong and healthy bones requires an adequate dietary intake of calcium and exercise beginning in childhood and adolescence for both sexes. Taking calcium supplements alone is not sufficient in treating osteoporosis. After menopause for several years, rapid bone loss can occur even if calcium supplements are taken.

The following calcium intake can be used for all people.

800 mg/day for children ages 1 to 10
1000 mg/day for men, premenopausal women, and postmenopausal women also taking estrogen
1200 mg/day for teenagers and young adults ages 11 to 24
1500 mg/day for postmenopausal women not taking estrogen
1200 mg to 1500 mg/day for pregnant and nursing mothers
The total daily intake of calcium should not exceed 2000 mg

Daily calcium intake can be calculated by the following methods:

Excluding dairy products, the average diet contains 250 mg of calcium
There is approximately 300 mg of calcium in an 8-ounce glass of milk
There is approximately 45-0 mg of calcium in 8 ounces of plain yogurt
There is approximately 1300 mg of calcium in 1 cup of cottage cheese
There is approximately 200 mg of calcium in 1 ounce of cheddar cheese
There is approximately 90 mg of calcium in ½ cup of vanilla ice cream
There is proximately 300 mg of calcium in 8 ounces of calcium-fortified orange juice. [11]

Vitamin D

An adequate calcium intake and adequate body stores of vitamin D are important foundations for maintaining bone density and strength. Vitamin D is classified in the following ways.

Vitamin D helps the absorption of calcium from the intestines
A lack of Vitamin D causes calcium-depleted bone, which further weakens the bones and increases the risk of fractures.

Vitamin D along with adequate calcium has been shown in some studies to increase bone density and decrease fractures in older postmenopausal but not in premenopausal or per menopausal women. [9]

Nutrition

Vitamin D helps make the bones strong. Good sources of calcium are

Low-fat milk, yogurt, and cheese
Foods with added calcium such as orange juice, cereals, and breads

Vitamin D is needed for strong bones. Vitamin D makes the body with sun effective though out of way to the sun. The amount of calcium and vitamin D required each day to all persons depends upon their age. [9]

Age	Calcium	Vitamin D
0-6 months	210 mg	200 IU
7-12 months	270 mg	200 IU
1 to 3 years	500 mg	2-00 IU
4-8 years	800 mg	200 IU
9-18 years	1,300 mg	200 IU
19 to 50 years	1,000 mg	200 IU
51 to 70 years	1,200 mg	400 IU
Over 70 years	1,200 mg	600 IU

In the U.S. today, 10 million individuals already have osteoporosis and 34 million more have low bone mass, placing them at risk for this disease. More than 2 million American men suffer from osteoporosis, and millions more are at risk. Each year, 80,000 men suffer a hip fracture and one-third of these men die within a year. Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, and approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures at other sites. Estimated national direct expenditures (hospitals and nursing homes) for osteoporosis and related fractures are $14 billion each year. [6]

Conclusion

Osteoporosis mainly affects women after the age of menopause. Even it may occur younger people About three million people in the United Kingdom have the condition and which is more common in women than men. Every year more than 230,000 fractures occur because of osteoporosis. One in two women and one in five men over the age of 50 will have a fracture. Osteoporosis assessment and management is an important factor in maintaining the health of bone structure when entering middle age. The medication can be applied with Calcium and vitamin D supplements, a variety of hormone treatments including HRT and SERMS and Bisphosphonates, etc.

Osteoporosis is not an aging disease or an estrogen or calcium deficiency but it is a degenerative disease of Western Culture. With regards to kids, a review of 19 studies indicated that kids do not benefit from calcium supplements and fortified foods, despite may not meeting recommended daily intakes of the mineral.

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