This is not something to ignore, as left untreated it can lead to falls and then hip fractures.

Around 25 percent of people die within the first six to 12 months after a hip fracture.

What Is Osteoporosis?

Osteoporosis means “porous bones.” Our bones are strongest at about age 30, then begin to lose density.

About half of women 50 and older will have an osteoporosis-related fracture in their lifetime.

Symptoms

Unfortunately you might not even realise you have osteoporosis until you have a fracture or an obvious change in posture.

It is a silent disease with few symptoms in its early stages

In fact, you could have significant bone loss without even knowing it. Back pain, caused by changes in the vertebrae, may be the first sign that something is wrong.

Fractures

Osteoporosis is the underlying cause of 1.5 million fractures every year. Spinal compression fractures are the most common — tiny fractures that can cause the vertebrae to collapse and alter the shape of the spine.

Hip fractures can cause lasting mobility problems and even increase the risk of death. Wrist, pelvic, and other fractures are also common in people with osteoporosis.

What causes it?

Our bones are constantly being rebuilt throughout our lifetime. Bones are made up of collagen, a protein that provides the basic framework, and calcium phosphate, a mineral that hardens the bone.

As we age, we lose more bone than we replace. The greatest change in a woman’s bone density comes in the five to seven years after menopause.

Is it inevitable?

Bone loss is a natural part of aging, but not everyone will lose enough bone density to develop osteoporosis. However, the older you are, the greater your chance of having osteoporosis.

Women’s bones are generally thinner than men’s and bone density has a rapid decline for a time after menopause, so it’s not surprising that about 80% of those with osteoporosis are women.

Risk factors you can’t control

Women who are thin and have a small frame are more likely to develop osteoporosis. Heredity plays a role, and so does ethnicity.

It is more common among whites and Asians, though African-Americans and Hispanics may still be at risk.

Some conditions, such as type 1 diabetes, rheumatoid arthritis, inflammatory bowel disease, and hormonal disorders are also linked to bone loss.

Risk factors you can control

Smoking, an inactive lifestyle, and a diet low in calcium and vitamin D place you at greater risk for osteoporosis.

Excess drinking is linked to bone loss and a risk of fractures.

Corticosteroids, anti-inflammatory drugs used to treat asthma and other conditions, increase your risk of bone loss.

Eating disorders (anorexia nervosa or bulimia) can also take a toll on bone health.

Do men get osteoporosis?

Osteoporosis is much more common in women, but men are at risk, too. In fact, about 25% of men over 50 will have an osteoporosis-related fracture.

Osteoporosis may be under-diagnosed in men because it is often considered a “woman’s disease” and men may not be tested.

How will I know?

Your doctor may recommend a bone mineral density test if:

You’re over 50 and have broken a bone
You are a woman over 65, or a man over 70
You are in menopause or past menopause and have risk factors
You are a man age 50-69 with risk factors

This will usually be at a hospital and is a DXA scan (dual X-ray absorptiometry). This uses low-dose X-rays to measure bone density in the hip and spine.

Also available is ultrasound testing, usually privately, and this is less invasive.

Testing compares your density (BMD) with that of a healthy 30-year-old, since that’s when bone mass is at its peak.

The results come as a T-score in these ranges:
-1.0 and higher is normal bone density
Between -1.0 and -2.5 shows low bone density (osteopenia) but not osteoporosis
-2.5 or below indicates osteoporosis

As your bone density decreases, your T-score gets lower.

Treatment

If you are diagnosed with osteoporosis, you may be prescribed a biophosphonate: Actonel, Boniva, Fosamax, or Reclast but these do carry some health risks and certainly unpleasant side effects.

They can reduce bone loss and fracture risk and may help build some bone density. Those taken by mouth can cause gastrointestinal problems such as ulcers in the oesophagus, acid reflux, and nausea.

Injectable bisphosphonates, given one to four times a year, can cause brief flu-like symptoms. Bisphosphonates may increase risk of jaw bone destruction and atypical femur fractures.

Natural treatment

Bioidentical natural progesterone has been used for many years worldwide to treat osteoporosis. In the process of bone rebuilding, it is oestrogen that breaks down old bone, but progesterone which helps build new bone.

Because our bones continue to break down and be replaced throughout our lives it is essential to have good hormone balance.

Your diet can also help so include calcium-rich foods such as milk, salmon, tuna, and herring also contain vitamin D, which helps us absorb calcium, and leafy green vegetables also provide magnesium, which helps maintain good bone quality.

Weight-bearing exercise can help you build bone and maintain it. That includes walking, jogging, dancing, tennis, and other activities where you move the full weight of your body.

Women who walk just a mile a day have four to seven more years of bone reserve, researchers have found. While yoga and Pilates can help with balance, too much twisting or forward-bending can increase the risk of spinal compression fractures in people who have osteoporosis.

High-impact activities also can be risky for people with low bone density. Swimming and bicycling can be great exercise, but they are not weight-bearing and therefore not as effective in providing bone-health benefits.

Avoid these for healthy bones

Some foods can sap your body’s calcium. Minimise salty foods such as canned soups and processed meats.

Caffeine can decrease your body’s absorption of calcium, but the effect is minimal unless you drink more than three cups of coffee a day.

Heavy alcohol use can also lead to bone loss.

Osteopenia

If you have bone loss but not enough to be osteoporosis, you may have a condition called osteopenia. As with osteoporosis, there are no physical symptoms.

Osteopenia can progress to osteoporosis, but with changes in diet and exercise, you can slow the bone loss.

It’s never too late

Many people don’t find out about their bone loss until they are in their 60s or older. But you can still benefit from boosting a low calcium intake, having a good diet and regular weight bearing exercise.

Supplementing with both progesterone and a specific osteoporosis supplement to recommended levels can help as can exercises such as tai chi to improve balance, which can help prevent falls.