Osteoporosis is a chronic condition that causes a loss of bone strength, resulting in fragile bones at an increased risk of fracture. Some people don’t realise they have osteoporosis until a normal movement like standing or walking causes a bone fracture. Osteoporosis is a lifelong condition that can be managed, but not cured.
You are at higher risk of developing osteoporosis once you have passed through the menopause, and the risk of sustaining an associated bone fracture increases with age.
Estrogen plays an important part in the process of maintaining bone density. As estrogen production declines in the post-menopausal years, bones can become more fragile.
If you experienced early menopause (before the age of 45), or had your ovaries removed, you are at greater risk of developing osteoporosis.
Bone fractures can cause significant impact on health that becomes more worrying with age, so early diagnosis and treatment of osteoporosis are vital.
What happens to bones in osteoporosis?
If you were to view a healthy bone through a microscope, you would see lots of tiny holes and spaces interspersed throughout the structure, like a honeycomb.
In osteoporosis, these holes and spaces become bigger, reducing the overall density of the bone. The outer layer of the bone also becomes thinner.
Bone density starts to decline from around the age of 30, but falling levels of estrogen after the menopause accelerate the process.
Why do we need to be aware of osteoporosis?
Any bone fracture is traumatic, sustaining a fracture later in life can significantly impact your health. Fractures to hips, or other bones that support your weight, like the pelvis or spine, are particularly concerning.
Sustaining a fracture in one of these major bones puts you at increased risk of becoming dependent on others for your basic daily needs. In some cases, a bone fracture results in loss of mobility, leading to further complications associated with a higher risk of death.
After one bone fracture, you are at increased risk of fracturing another bone within the next 12 months.
The good news is that there are ways to improve your overall bone health and minimise fracture risks as you age. Lifestyle factors play a part in managing risk, and many effective medicines are available to help prevent bone fractures caused by osteoporosis. Your doctor will help you decide on suitable treatments.
How is osteoporosis diagnosed?
Your doctor may assess your risk of bone fracture using a screening tool that estimates the risk of a menopausal woman fracturing a bone in the next ten years.
As part of this assessment, your doctor will look at:
Your medical history
Your age, whether you have gone through menopause, and any history of bone fractures can help build a picture of your likelihood of having osteoporosis.
Blood tests
Blood tests alone are not enough to diagnose osteoporosis, but they can help give your doctor an idea of your general health. Your doctor can also test for other conditions that can affect bone health, like thyroid problems or some cancers.
A bone density scan
Bone mineral density levels are assessed by a scan that uses a specialised technique known as DXA, or DEXA. This bone density scan is painless and lasts for around 10-20 minutes. The report from your DXA scan tells your doctor about your overall bone health, and the degree of bone loss detected.
You can also be diagnosed with osteoporosis after sustaining a bone fracture from a minor injury or movement. However, your doctor might still ask for a DXA scan to gauge the severity of bone loss to help guide treatment.
Sometimes, even after sustaining a fracture, your DXA scan might show normal bone density. In this case, the fracture may have been caused by a deterioration in overall bone strength; a common side effect of ageing.
Osteopenia
Osteopenia is a condition where bone mass is lower than it should be, but not low enough to diagnose osteoporosis. If you have osteopenia, you are at greater risk of breaking a bone than most people.
It can be a warning sign that you risk developing osteoporosis if you don’t take measures to build up your bone strength.
There is some evidence that stopping smoking, reducing caffeine intake, and getting plenty of exercise can lower your risk of developing osteoporosis. Consult your doctor for advice.