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Osteoporosis In Women: Causes, Risk Factors & Treatment

According to the International Osteoporosis Foundation, it is estimated that osteoporosis affects about 200 million women worldwide. In comparison to men, women are much more likely to be affected by osteoporosis. The condition is commonly found in women because, they start losing bone mass quickly with age, due to low bone density [1] .

An average woman aged between 20 and 80 years loses one-third of her hip bone density compared to men. The condition is known to develop especially after menopause because it is when the bones begin to lose density and turns weak [2] . Studies have revealed that white and Asian women are at a higher risk of developing the condition.

Bone resorption is a natural process which enables the transfer of calcium from bone tissue into the bloodstream and is required to allow the bone to adapt itself to challenges (e.g. change in a person's activity levels) and repair damage. However, if excessive and not balanced by equivalent bone formation, over time this can be detrimental to bone health[3] .

A study based on South Asian women revealed that pre-menopausal South Asian women had higher levels of urinary N terminal telopeptide - a by-product of bone resorption found in urine -- than their white counterparts, indicating elevated levels of bone resorption than would be expected for their age [3] .

Symptoms Of Osteoporosis In Women

In the early stages of the condition, there are no particular signs. The symptoms only begin to show once the bones have become too weak and fragile [4] .

  • Bones that break easily
  • Back pain
  • A stooped posture

Causes Of Osteoporosis In Women

Women develop the condition in large when compared to that of men. The hormone oestrogen is responsible for maintaining a healthy bone density, which tends to drop once a woman reaches menopause [5] . The considerable loss in the oestrogen levels causes a decrease in bone density, which thereby results in the development of osteoporosis.

Apart from these, the major causes of osteoporosis in women are breast cancer, calcium deficiency, corticosteroid therapy (a steroid replacement hormone), eating disorder, excessive exercise, hypothyroidism, hypopituitarism and vitamin D deficiency [6] .

Risk Factors Of Osteoporosis In Women

Some of the major risk factors pertaining to the condition in women are as follows [6] :

  • Old age
  • Race
  • Menopause
  • Small body frame (thin)
  • Genetic influence
  • Certain medications
  • Poor diet habits
  • Unbalanced hormone levels
  • Heavy alcohol consumption and smoking

A number of these risk factors are unchangeable, such as your sex, age, race, family history and body frame. However, there are some of it which can be changed such as dietary habits, lifestyle choices and medications.

Women who have the following medical conditions are also at a high risk of developing osteoporosis [7] [8] :

  • Rheumatoid arthritis
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Celiac disease
  • Lupus
  • Cancer
  • Multiple myelomas

Osteoporosis In Men: Risk Factors And Tips To Prevent It

Diagnosis Of Osteoporosis In Women

The doctor will ask about your family history and inquire about other factors such as your diet, lifestyle habits and the like [9] .

If osteoporosis is suspected, a scan will be required, so as to measure your bone mineral density. In order to scan your bone density, a type of x-ray technology known as dual-energy X-ray absorptiometry (DEXA) and bone densitometry is used[10] .

The diagnosis can be carried out using two different devices, such as a central device (a hospital-based scan) and a peripheral device (a mobile machine).

The results from the DEXA scan are termed as DEXA T-score or a Z-score, where the score will be compared with peak bone mass of a younger person. A T-score of -1.0 or above is normal, -1.0 to -2.5 suggests mild bone loss and -2.5 or below indicates osteoporosis [11] .

Treatment For Osteoporosis In Women

If the condition is not severe, the treatment method will not include any medications but will be comprised of measures to manage and avoid the risk factors. Upon understanding the root cause of the condition, a suitable treatment method will be adopted [12] .

Medications such as bisphosphonates will be prescribed. It may have side effects such as nausea, abdominal pain and heartburn-like symptoms [12] . Apart from that estrogen agonist or antagonists, also known as selective estrogen-receptor modulators, SERMS), calcitonin, parathyroid hormone and monoclonal antibodies are prescribed for women.

Basically, the treatment aims to slow down the development of the condition, maintain a healthy bone mineral density and bone mass, prevent fractures and manage the pain [13] .

Osteoporosis: Symptoms, Causes & Treatment

Prevention Of Osteoporosis In Women

Some of the measures you can adopt to manage and control the condition are as follows [14] [15] :

  • Avoid smoking
  • Avoid excessive alcohol consumption
  • Be cautious and avoid falls
  • Add calcium and vitamin D in your diet
  • Regular weight-bearing exercise, such as walking
  • Exercises to promote flexibility and balance, such as yoga

On A Final Note...

It has to be taken in to notice that, osteoporosis is not exclusive to older women but can affect young people as well, including pre-menopausal women aged 20, 30 and 40 years. Some pregnant women develop a temporary type of osteoporosis during pregnancy. This is a rare case however and usually goes away after the delivery.

View Article References
  1. [1] Rigotti, N. A., Nussbaum, S. R., Herzog, D. B., & Neer, R. M. (1984). Osteoporosis in women with anorexia nervosa.New England Journal of Medicine,311(25), 1601-1606.
  2. [2] Leech, J. A., Dulberg, C., Kellie, S., Pattee, L., & Gay, J. (1990). Relationship of lung function to severity of osteoporosis in women 1-3.The American review of respiratory disease,141(1), 68-71.
  3. [3] Borer, K. T. (2005). Physical activity in the prevention and amelioration of osteoporosis in women.Sports medicine,35(9), 779-830.
  4. [4] Gourlay, M. L., Fine, J. P., Preisser, J. S., May, R. C., Li, C., Lui, L. Y., ... & Ensrud, K. E. (2012). Bone-density testing interval and transition to osteoporosis in older women.New England Journal of Medicine,366(3), 225-233.
  5. [5] Aitken, J. M. (1984). Relevance of osteoporosis in women with fracture of the femoral neck.Br Med J (Clin Res Ed),288(6417), 597-601.
  6. [6] Iskrant, A. P., & Smith Jr, R. W. (1969). Osteoporosis in women 45 years and over related to subsequent fractures.Public Health Reports,84(1), 33.
  7. [7] Ramaswamy, B., & Shapiro, C. L. (2003, December). Osteopenia and osteoporosis in women with breast cancer. InSeminars in oncology(Vol. 30, No. 6, pp. 763-775). WB Saunders.
  8. [8] Compston, J. E., Wyman, A., FitzGerald, G., Adachi, J. D., Chapurlat, R. D., Cooper, C., ... & LaCroix, A. Z. (2016). Increase in fracture risk following unintentional weight loss in postmenopausal women: the global longitudinal study of osteoporosis in women.Journal of Bone and Mineral Research,31(7), 1466-1472.
  9. [9] Cosman, F., Crittenden, D. B., Adachi, J. D., Binkley, N., Czerwinski, E., Ferrari, S., ... & Zerbini, C. A. (2016). Romosozumab treatment in postmenopausal women with osteoporosis.New England Journal of Medicine,375(16), 1532-1543.
  10. [10] Miller, P. D., Hattersley, G., Riis, B. J., Williams, G. C., Lau, E., Russo, L. A., ... & Fitzpatrick, L. A. (2016). Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial.Jama,316(7), 722-733.
  11. [11] Pecina, J. L., Romanovsky, L., Merry, S. P., Kennel, K. A., & Thacher, T. D. (2016). Comparison of clinical risk tools for predicting osteoporosis in women ages 50–64.J Am Board Fam Med,29(2), 233-239.
  12. [12] Kim, O. S., Shin, M. H., Song, I. H., Lim, I. G., Yoon, S. J., Kim, O. J., ... & Chung, H. J. (2016). Digital panoramic radiographs are useful for diagnosis of osteoporosis in Korean postmenopausal women.Gerodontology,33(2), 185-192.
  13. [13] Kanis, J. A. (2019). Diagnosis and Clinical Aspects of Osteoporosis. InPocket Reference to Osteoporosis(pp. 11-20). Springer, Cham.
  14. [14] Qaseem, A., Forciea, M. A., McLean, R. M., & Denberg, T. D. (2017). Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians.Annals of internal medicine,166(11), 818-839.
  15. [15] Golob, A. L., & Laya, M. B. (2015). Osteoporosis: screening, prevention, and management.Medical Clinics,99(3), 587-606.

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