Osteoporosis literally means ‘porous bones’. Our bones are made
of a thick outer shell and a strong inner mesh which looks like honeycomb.
Osteoporosis occurs when the holes between this bony mesh become bigger.
This leads to the skeleton becoming so porous that the slightest knock or
fall can break a bone, usually in the wrist, spine or hip.
Osteoporosis affects one in three women and one in 12 men over the age of
50 but it can affect people of all ages. Bone loss occurs naturally to everyone
as they get older but osteoporosis is not an inevitable part of ageing and
it can be treated.
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Patient Information
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What is Osteoporosis?
Who is affected?
Our bones are alive and
constantly changing. A child’s skeleton is replaced within a couple
of years while an adult’s bones are renewed over about a decade. So
how you live your life will affect your skeleton and influence the health
of your bones.
Women are more at risk of developing osteoporosis than men because they have smaller, lighter bones and they go through the menopause. Osteoporosis in men often develops because of another health problem, such as low levels of the male hormone testosterone. But in nearly half of all cases in men the cause is unknown.
There are also other factors which can increase both men and women’s risk of osteoporosis:
Women are more at risk of developing osteoporosis than men because they have smaller, lighter bones and they go through the menopause. Osteoporosis in men often develops because of another health problem, such as low levels of the male hormone testosterone. But in nearly half of all cases in men the cause is unknown.
There are also other factors which can increase both men and women’s risk of osteoporosis:
Causes
Your genes largely determine how strong your skeleton will become although the way you live your life can influence bone health.
There are two cells at work in our bones: osteoblasts which build up new bone and osteoclasts which break down old bone. This process is called bone turnover. Bones reach their maximum potential strength in your mid-20s so it is important to 'bank' as much bone as possible during this time. Up to the age of 35, a balance between bone breakdown and new bone formation means that bone density stays stable. From mid to late 30s, bone loss increases as part of the natural ageing process. This can lead to osteoporosis and an increased risk of breaking a bone, particularly in women, due to accelerated bone loss at the menopause.
There are two cells at work in our bones: osteoblasts which build up new bone and osteoclasts which break down old bone. This process is called bone turnover. Bones reach their maximum potential strength in your mid-20s so it is important to 'bank' as much bone as possible during this time. Up to the age of 35, a balance between bone breakdown and new bone formation means that bone density stays stable. From mid to late 30s, bone loss increases as part of the natural ageing process. This can lead to osteoporosis and an increased risk of breaking a bone, particularly in women, due to accelerated bone loss at the menopause.
What else can I do?
There are ways to help keep your bones healthy:
Take plenty of exercise. Weight bearing exercise like jogging and tennis are good builders but if you have osteoporosis then you need to be more cautious. It's certainly good to keep active as you get older because it lessens your risk of falling, and therefore breaking a bone if you have osteoporosis.
Eat a healthy diet, including plenty of calcium-rich foods, like dairy products, green leafy vegetables and tinned fish.
If you are a smoker you should consider giving up. Smoking has a toxic effect on the skeleton and stops the cells which make new bone from working effectively.
Don't drink too much alcohol which is also damaging to bone. Try to limit your alcohol intake to a maximum of three to four units a day for men and two to three units for women. And it is always good to have alcohol free days as well.
Take plenty of exercise. Weight bearing exercise like jogging and tennis are good builders but if you have osteoporosis then you need to be more cautious. It's certainly good to keep active as you get older because it lessens your risk of falling, and therefore breaking a bone if you have osteoporosis.
Eat a healthy diet, including plenty of calcium-rich foods, like dairy products, green leafy vegetables and tinned fish.
If you are a smoker you should consider giving up. Smoking has a toxic effect on the skeleton and stops the cells which make new bone from working effectively.
Don't drink too much alcohol which is also damaging to bone. Try to limit your alcohol intake to a maximum of three to four units a day for men and two to three units for women. And it is always good to have alcohol free days as well.
How do I know if I have osteoporosis?
Osteoporosis is called 'the silent disease' because you cannot feel your bones getting thinner. So you will probably be unaware of any problems until you get the first sign. Unfortunately for most, this is a painful broken bone, often in the wrist, hip or spine, after a slight fall.
If you have broken a bone after only a minor trauma or think you may be at risk then make an appointment with your GP to discuss your concerns. Your doctor may decide to investigate further and send you to hospital to have your bones specially scanned in a simple, painless procedure which uses very low doses of radiation. Alternatively, an x-ray can sometimes reveal if the bones in your spine have fractured.
What treatment can I take?
The treatment
of osteoporosis depends on your age, sex, medical history and which bones
are broken. Doctors can currently prescribe treatments aimed at stopping
any further bone loss which hopefully then reduces the risk of further broken
bones.
Bisphosphonates
These drugs act by slowing down the cells which break down bone during the skeleton's normal growth cycle.
Hormone replacement therapy
This is includes both oestrogen replacement for women at the menopause and testosterone therapy for men. HRT in women is no longer a first line treatment for osteoporosis and is only considered if a woman primarily needs to control menopausal symptoms.
Selective estrogen receptor modulator (SERM)
This is a non-hormonal drug for women which mimics the protective effects of oestrogen on bone without some of the side effects of HRT.
Calcium and vitamin D
These supplements can be good for older people, those with poor appetites or people who do not regularly get outside into the sunshine. Sunlight helps the body manufacture vitamin D which is needed to absorb calcium.
There are also a range of other treatments which are generally only prescribed by specialists. These include calcitonin and calcitriol, as well as teriparatide, a new drug which actually builds new bone.
These drugs act by slowing down the cells which break down bone during the skeleton's normal growth cycle.
Hormone replacement therapy
This is includes both oestrogen replacement for women at the menopause and testosterone therapy for men. HRT in women is no longer a first line treatment for osteoporosis and is only considered if a woman primarily needs to control menopausal symptoms.
Selective estrogen receptor modulator (SERM)
This is a non-hormonal drug for women which mimics the protective effects of oestrogen on bone without some of the side effects of HRT.
Calcium and vitamin D
These supplements can be good for older people, those with poor appetites or people who do not regularly get outside into the sunshine. Sunlight helps the body manufacture vitamin D which is needed to absorb calcium.
There are also a range of other treatments which are generally only prescribed by specialists. These include calcitonin and calcitriol, as well as teriparatide, a new drug which actually builds new bone.
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