A 65-year-old woman who was well past menopause was complaining of back pain. Gradually, her posture grew hunched over. Diagnostic tests were performed after the patient saw the doctor, and the results showed that the severe back pain was being caused by a broken vertebra. It was evidently osteoporosis.
About Osteoporosis
Osteoporosis is a disorder where the bones become porous as a result of calcium loss. This weakens the bones over time, eventually resulting in fractures. It has been noted that women are more likely to develop osteoporosis, particularly after menopause.
The human body constantly remodels its bone structure, resulting in the loss of old bone and the creation of new bone. When a person is young, their bone mass increases because their body is making more bone than they are losing. About 30 years of age is when bone mass reaches its peak. From that point on, more bone is lost than is made. Women’s estrogen levels sharply decline following menopause or surgical ovarian excision, hastening the loss of bone and resulting in osteoporosis.
The other risk factors of osteoporosis include
- Menopause occurring before age 45 years
- Surgical removal of ovaries
- Deficiency of calcium
- Family history of menopause
- Belonging to Asian or Caucasian race
- Sedentary lifestyle
- Thin and small body frame
- Alcohol abuse
- Smoking
- Anorexia nervosa (eating disorder)
- Hyperthyroidism (thyroid gland being overactive)
- Medications used for hypothyroidism (thyroid gland being underactive)
- Use of corticosteroid medications
When osteoporosis results in a fractured vertebra, it can cause excruciating back pain. Additionally, fractures may occur in the wrist and hip bones. The afflicted individual has a hunched posture and gradually loses height.
Diagnosis
Dual X-ray absorptiometry (DEXA) is a screening test used to measure bone density. It measures the density of the wrist, spine, and hip bones. Quantitative computerized tomography, ultrasound, and single photon absorptiometry are additional tests that aid in determining bone density.
Treatment
There are medications that help in treating osteoporosis.
Biphosphonates: The biphosphonates help in increasing the density of bones in the spine and the hip, and help reduce the risk of bone fractures. They are taken in the form of intravenous injection or in the form of oral pills. The biphosphonates cannot be taken by people who have low calcium levels in blood, pregnant women, and people who are having kidney disease. The side effects that can occur due to biphosphonates include esophageal irritation, vision problems, irregular heartbeats, osteonecrosis of jaw (bone loss in jaw), abdominal pain, and nausea.
Calcitonin: The thyroid gland secretes the hormone calcitonin, which helps to slow down bone loss and reduce the risk of spine fractures. It is available in the form of an injection or nasal spray. There can be nasal irritation in some people due to the use of nasal spray. It is generally used by people who can’t take biphosphonates.
Raloxifene: Raloxifene gives the same beneficial effects of the hormone estrogen without causing any risks. It helps in increasing the bone density in post-menopausal women without causing any risks like uterine cancer or breast cancer. Individuals who have experienced blood clots in the past should not take raloxifene. The adverse effect of this medication is having hot flashes.
Alendronate and risendronate: By slowing down the rate of bone loss, these drugs lower the chance of fracture. They are taken as pills. Stomach upset is a common side effect that may occur.
Ibandronate: Ibandronate helps in increasing the density of bone and reducing bone resorption. The medication is given in the form of injection once in 3 months. It comes in pill form and can be taken either daily or once a month. The drug’s adverse effects include lower back pain, chest tightness, shortness of breath, and bloody urine.
Terparatide: This medication helps in bone growth. It is a type of artificially produced parathyroid hormone. It is given in the form of injection into the abdomen or thigh in both men and women. Abdominal pain, headaches, nausea, muscle weakness, and loss of appetite are some of the side effects that are observed.
Calcium requirement
Prior to menopause, women need 1000 mg of calcium per day. Calcium needs are 1500 mg daily if a woman is not taking estrogen after menopause and 1000 mg daily if she is. Dairy products, cheese, milk, spinach, broccoli, pink salmon, and dried beans are among the foods high in calcium. Vitamin D is used by the body to help absorb calcium. Thus, foods high in vitamin D, such as liver, egg yolks, saltwater fish, fish oils, and fortified milk, should be consumed.
Tips to keep bones strong
Regular exercise is necessary to maintain strong bones and prevent osteoporosis. Weight bearing activities such as jogging, stair climbing, skipping rope, walking, and sports activities help to build strong bones, while strength training exercises help to strengthen the muscles and bones of the upper spine and arms. There should be at least 1000 mg of calcium per day in the diet. Since smoking reduces a woman’s ability to produce estrogen, which causes bone loss, it should be strictly avoided. Drinking more than two alcoholic beverages significantly reduces the formation of new bone.
Support
After menopause, women should be aware of osteoporosis and its debilitating consequences. By adopting the appropriate preventive measures, one can significantly strengthen the bones.
