Osteoporosis is a disease in which there is loss of bone tissue (and so loss of bone density), causing bones to become brittle and fracture easily.

OSTEOPOROSIS CAUSES

Thinning of the bones is a natural part of the aging process. However, women are especially vulnerable to loss of bone density after the menopause, because their ovaries no longer produce oestrogen hormones, which help maintain bone mass.

Other causes of osteoporosis include premature removal of the ovaries; a diet that is deficient in calcium; certain hormonal disorders, such as an overactive thyroid gland (hyperthyroidism); long-term treatment with corticosteroid drugs; and prolonged immobility. Osteoporosis is most common in heavy smokers and drinkers, and in very thin people.

OSTEOPOROSIS SYMPTOMS

Osteoporosis may go undiagnosed for many years. The first sign is often a fracture, typically at the wrist or the top of the femur (thigh bone), after what may have been a trivial injury. One or several vertebrae may fracture spontaneously and cause the bones to crumble, leading to progressive height loss and/or pain due to compression of spinal nerve roots.

OSTEOPOROSIS DIAGNOSIS AND TREATMENT

Osteoporosis id confirmed using densitometry, such as a DEXA scan.

Bone loss can be minimized with adequate dietary calcium and vitamin D, and regular, sustained exercise to build up the bones and maintain their strength. Disphosphonate drugs may be prescribed to help prevent bone loss. If these drugs are not suitable, raloxifene, strontium ranalate, or calcitonin may be given.  Hormone replacement therapy (HRT) may be considered for postmenopausal women when other treatments have been ineffective or unsuitable. Women who have gone through a premature menopause (before the age of 45) may be advised to have HRT until the age of 50 to protect against their higher risk of osteoporosis.

BONES IN OSTEOPOROSIS

In osteoporosis. the density of the bones decreases, and their brittleness increases, although there is no change in size or composition. Women past the menopause are the most commonly affected because their ovaries no longer produce oestrogen, which helps to maintain bone mass. The risk of the condition is greater in woman who undergoes the menopause early, or whose mother had osteoporosis.

In a normal bone cross section, bone consists of collagen (a protein), which give elasticity, and calcium, which gives hardness. In the osteoporotic bone, thinning is mainly due to loss of collagen, which takes calcium with it. Both hard and spongy bone tissues are affected.

When compared with normal bone tissue, the osteoporotic bone is far less dense and appears thin and brittle.

By age 80, up to half of all women have sustained at least one fracture due to osteoporosis, a much higher proportion than in men.

Source: A-Z family medical encyclopedia by BMA

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