• Accelerated bone loss after menopause is a major cause of osteoporosis in women, and preventive action is the only recourse, says Dr Rajeev K Sharma leading orthopaedic specialist and joint replacement surgeon
New Delhi, April, 2014: Osteoporosis is a disorder characterized by depleted bones that make you more prone to fractures and injuries. It is also a characteristic that runs parallel to a person’s age and inflicts more women than men. This is why women need to invest in bone health from early on in their lives.
The process called ageing brings in its wake a series of changes in the body. As we grow wiser, we also realize that our body that was once at our command will not be so all our lives. As muscles weaken, eyes give in, hair turns grey and skin loses its sheen, you know they are telling you that they have withered a lot. So are your bones. Bone mass or density is lost as we age. This happens in both men and women but it especially aggravates in women after menopause.
“As a part of ageing processes both men and women lose their bone density by 0.3% to 0.5% after the age of 35 yrs. In women estrogen (a hormone) is important in maintaining bone density. When estrogen levels drop after menopause, the loss of bone density accelerates. Deficiency of calcium and vitamin D can aggravate osteoporosis, though it is not the main and only cause,” says Dr Rajeev K Sharma, leading Orthopedic Specialist and Joint Replacement Surgeon at Indraprastha Apollo Hospitals, Delhi.
The bones lose calcium, vitamin D and other minerals and start losing their density. In extreme cases they become abnormally porous and fragile and extremely susceptible to fractures. This extreme condition is often described as Osteoporosis and can become a dangerous part of the lives of many an elderly. This is why we hear about so many hip, knee and shoulder fractures in older people. It is hence important to understand the way the condition works and aggravates.
According to estimates, as many as 25 million Indians are likely affected by osteoporosis. In fact, in India osteoporotic fractures may be occurring at a younger age than in the West. Recent research and studies have pointed out to the widespread vitamin D deficiency across India. The high prevalence of vitamin D deficiency is a major factor in the poor bone health of Indians. Poor sunlight exposure and a vitamin D-deficient diet are some obvious causes.
“The bad news is that osteoporosis will be present in human body without any symptoms for decades and it doesn't cause symptoms until the bones start fracturing. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Hence, the patients may not be aware of their osteoporosis problem until they suffer a painful fracture. Depending on the location of fracture the symptoms differ but the usual symptom is pain and disability,” says Dr Sharma.
During the first five to 10 years after menopause, women can suffer up to 2%-4% loss of bone density per year! This can result in the loss of up to 25%-30% of their bone density during that time. Accelerated bone loss after menopause is a major cause of osteoporosis in women. Hormone replacement therapy post-menopause prevents this loss, but is of no major help once the window period of six years post-menopause is over.
Risk factors
• Cigarette smoking
• Alcohol consumption.
• Poor nutrition and a diet low on calcium and vitamin D
• Low estrogen levels
• Chemotherapy that can cause early menopause due to its toxic effects on the ovaries.
• Loss of menstrual period in young women (Amenorrhea) and it can occur in women who undergo extremely vigorous exercise training or with very low body fat, e.g, women with anorexia nervosa.
• Rheumatoid arthritis or liver diseases
• Immobility, such as after a stroke or from any condition that interferes with walking.
• Hyperthyroidis or the problem of excessive sweating
• Long-term use of anti-seizure medications and long-term use of oral steroids.
Prevention
The age old adage that prevention is better than cure holds 100 per cent in the case of osteoporosis. In fact, the only way to prevent osteoporosis is to start working with your bones when they are still young. Do not let bone loss to set in early by faulty practices.
• Eat calcium rich diet
• Ensure adequate exposure to the sun for vitamin D
• Get a routine bone density check-up after the age of 35
• Exercise to strengthen the bone
• Quit smoking and alcohol
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