Approximately one in two women older than 50, according to the National Osteoporosis Foundation, will break a bone because of osteoporosis. A woman’s risk of breaking a hip is equal to her combined total risk of breast, uterine and ovarian cancer.
What Is Osteoporosis?
Osteoporosis is a condition that affects bone strength. Our bones are made of collagen fibers and minerals. The cells that comprise our bones make, mold and reabsorb (or take back) bone. As we grow, our bone formation exceeds bone resorption, but after about the age of 35, this process reverses, and we begin to lose a certain amount of our bone mass. As we age, our bones lose density and strength, to varying degrees.
Why Are Women at Greater Risk Than Men?
There are many reasons that women are at a greater risk of developing osteoporosis than men. Women tend to have smaller, thinner bones than their male counterparts. In women, estrogen, a hormone that helps protect the bones, decreases sharply when she reaches menopause, which can lead to bone loss. Because of this, a woman’s risk of developing osteoporosis increases significantly as she leaves her childbearing years.
What Are My Risks for Developing Early-Onset Osteoporosis?
Osteoporosis among those younger than 50 is considered rare, but findings are showing that the disease may not be as rare as once believed. According to a study conducted by the University of Arkansas, 2 percent of college-aged women had bone densities low enough to be considered osteoporosis, and 15 percent had bone densities low enough to put them in the osteoporosis risk range.
About 50 percent of premenopausal women who have developed osteoporosis will have a secondary cause, ranging from medications and medical conditions to smoking and alcohol use.
Both men and women risk developing osteoporosis as they age, especially after 60. The following factors may increase our risk of developing early-onset osteoporosis:
● Entering menopause before the age of 45
● Having a bone fracture after a minor fall or bump
● Having a strong family history of osteoporosis (specifically, having a parent or sibling who has been diagnosed with the disease)
● Having a body mass index (BMI) or 19 of less (being very underweight). For those who are very underweight, estrogen levels are low for extended periods of time, and, combined with poor diet, can affect bone density and strength.
● Women who have periods that stop for six months to a year or more before the time of menopause, which can happen as a result of over-exercising or over-dieting, among other reasons
● People who have taken or are taking a steroid medicine, including prednisolone, for three months or more.
● If you are a smoker, you are at higher risk for early-onset osteoporosis.
● If you consume more than four drinks a day, you increase your odds of developing osteoporosis.
● People who lack calcium and vitamin D due to poor diet and limited exposure to sunlight are at an increased risk of developing this condition.
● People who have led a sedentary lifestyle rather than committing to regular exercise are at greater risk than those who are active and physically fit.
● On the contrary, however, women who were overly athletically active before the age of 30 and nutritionally deficient, a condition called AED or athletic energy deficiency, are often victims of early onset osteoporosis.
● People with certain medical conditions are at an increased risk, including: overactive thyroid, celiac disease, Cushing’s syndrome, Crohn’s disease, chronic kidney failure, rheumatoid arthritis, chronic liver disease, type 1 diabetes and conditions that cause poor mobility.
One of the biggest problems with osteoporosis, whether it is premenopausal or occurs later in life, is that it is often difficult to determine if you’re at risk for the disease until it’s too late and you’ve already experienced a fracture. Because the disease is painless and mostly asymptomatic, your best bet is to talk to a doctor about your personal risk factors related to early osteoporosis and determine whether a bone density screening may be an appropriate step to protect yourself.
How Is It Diagnosed?
Doctors can use a bone density screening, as well as a review of your medical history and the results of physical exams, X-rays and bloodwork to determine whether you have low bone density or osteoporosis. One of the best tests to determine bone density is a dual energy X-ray absorptiometry, or DXA - a painless test that takes only a few minutes to complete.
How Is Osteoporosis Treated?
Unfortunately, most of the osteoporosis medications approved by the FDA for treating the disease are not approved for use by premenopausal women. For women who have taken steroid medications for extended periods, there are three osteoporosis drugs that are approved for the prevention and treatment of the disease. In rare cases, such as when a woman breaks a bone because of low bone density or has severe bone loss due to a medical condition, a doctor may advise her to take an osteoporosis medication approved for use only in postmenopausal women.
In most cases, doctors will encourage a diet adjustment -- specifically, a diet rich in calcium and vitamin D, along with calcium and vitamin D supplements. Patients will be advised to avoid smoking and drinking, to develop a healthy exercise regimen and maintain a body mass index that falls within the normal weight range (rather than being underweight). Other general lifestyle changes can help with osteoporosis treatment.