Osteoporosis is a progressive condition in which bone density and structure are lost, thereby weakening the bones and making them more susceptible to fractures.

Osteoporosis is very prevalent in the US. It affects over 10 million individuals, with women four times more likely to develop osteoporosis than men. Estrogen deficiency is one significant cause of accelerated bone loss in women during and after menopause. However, testosterone deficiency in men can also be a risk factor.

Although the exact medical cause for osteoporosis is unknown, a number of factors contribute to osteoporosis, including the following:

• aging
  Bones become less dense and weaker with age.

• race
  Caucasian and Asian women are most at risk, although all races may develop the disease.

• body weight and bone structure
  People who weigh less and have small body frames are more at risk for developing osteoporosis.

• lifestyle factors:
  The following lifestyle factors may increase a person's risk of osteoporosis:
  
  
  • physical inactivity
  • excessive caffeine
  • excessive alcohol use
  • smoking
  • dietary calcium and vitamin D deficiency
    
    
• certain medications (corticosteroid, like Prednisone, excessive thyroid hormone)



• family history of bone disease

Persons with osteoporosis may not develop any symptoms. They do not have pain in their bones until they have a fracture. The symptoms of osteoporosis may resemble other bone disorders or medical problems. Always consult your physician for a diagnosis. The only outward symptom of osteoporosis is a bone breaking.

In addition to a complete medical history and physical examination, diagnostic procedures for osteoporosis may include the following:

• family medical history
  
  
• bone density test (Also called bone densitometry, DEXA or DXA) - measurement of the mass of bone in relation to its volume to determine the risk of developing osteoporosis.
  
  
• blood and urine tests (to measure serum calcium and other tests to rule out secondary causes of osteoporosis)

The effects of this disease can best be managed with early diagnosis and treatment.

Specific treatment for osteoporosis will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

The goals of managing osteoporosis are to decrease pain, prevent fractures, and minimize further bone loss. Some of the methods used to treat osteoporosis are also the methods to help prevent it from developing, including the following:

• Maintain an appropriate body weight.

• Increase walking and other weight-bearing exercises. Make sure not to fall. Talk to your doctor or a physical therapist about an exercise regimen.

• Minimize caffeine and alcohol consumption.

• Stop smoking.

• Maintain an adequate intake of calcium through diet and supplements. Vitamin D is also necessary because it facilitates the absorption of calcium.

• Prevent falls in the elderly to prevent fractures (i.e., install hand railings, or assistive devices in the bathroom, shower, etc.).

• Consult your physician regarding a medication regimen.

For postmenopausal osteoporosis in women, the US Food and Drug Administration (FDA) has approved the following medications to maintain bone health:

• estrogen replacement therapy (ERT) and hormone replacement therapy (HRT)
  ERT has proven to reduce bone loss, increase bone density, and reduce the risk of hip and spinal fractures in postmenopausal women. However, a woman considering ERT should consult her physician, as the recent study conducted by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) found health risks associated with this therapy.
  
  
• alendronate sodium (Fosamax®)
  This medication, from a group of medications called bisphosphonates, reduces bone loss, increases bone density, and reduces the risk of fractures.
  
  
• risedronate sodium (Actonel®)
  This medication is also from the bisphosphonate family and has similar effects as alendronate.
  
  
• raloxifene (Evista®)
  This medication is from a new group of medications called selective estrogen receptor modulators (SERMs) that help to prevent bone loss. (e.g. Miacalcin® Nasal Spray)



• calcitonin nasal spray
  This is a nasal spray.



• parathyroid hormone (Fortéo®)
  This medication is a form of parathyroid hormone, teriparatide, and is approved to treat postmenopausal women and men who are at high risk for fractures. It helps form bone.