Osteoperosis
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Osteoporosis, which means “porous bones,” is a preventable and treatable disease that thins and weakens your bones, making them fragile and more likely to break. It is sometimes called a “silent disease” because it can develop gradually over many years without causing any symptoms. The National Osteoporosis Foundation estimates as many as eight million women in the U.S. have osteoporosis, and that by 2020, 14 million individuals over age 50 will have osteoporosis.
Often, the first symptom of osteoporosis is a broken bone, also called a fracture, which typically happens at the hip, spine or wrist. Although men can also suffer from osteoporosis, the vast majority of individuals affected by osteoporosis are women. In fact, the annual number of osteoporoatic fractures in women is greater than the number of heart attacks, strokes and cases of breast cancer combined. Women are four times more likely to develop osteoporosis of the spine than men.
Although the disease can strike at any age, women are at greatest risk for osteoporosis after menopause. As many as 40 percent of women ages 50 years and older have osteoporosis. Thats because womens bodies produce less estrogen after menopause, and estrogen plays an important role in helping to prevent bone loss. Although the average age for menopause in the United States is 51, some women experience menopause earlier due to natural causes or following surgery, illness or treatments that destroy the ovaries. For example, a total hysterectomy in which the ovaries and uterus are removed will immediately trigger menopause. When you have not had a menstrual period for more than 12 consecutive months, without another medical reason for the absence of your periods, you are postmenopausal.
The good news is that osteoporosis can be prevented and treated and bone health can be maintained. And, its never too late to learn how to make and keep your bones healthy.
Medical Approaches to Treating Osteoporosis
The U.S. Food and Drug Administration (FDA) has approved medications for postmenopausal women to help slow or stop bone loss, build bone and reduce the risk of fractures, but only when they are taken regularly. As with any medication therapy, there are certain risks and side effects. Ask your health care professional about the risks and benefits of the recommended treatment for your specific health needs. A brief description of these medications follows:
Alendronate (Fosamax),
from the bisphosphonate class of drugs, is a bone-specific medication approved by the FDA to treat and prevent osteoporosis. Alendronate has been shown to increase bone mass and reduce the risk of spine, hip, wrist and other fractures by approximately 50 percent in women with osteoporosis. Alendronate has also been approved for the treatment of glucocorticoid-induced osteoporosis and treatment of osteoporosis in men. Alendronate tablets should be taken on an empty stomach in the morning and with eightounces of water at least 30 minutes before the first food, beverage or medication of the day. To minimize side effects–which can include heartburn or irritation of the esophagus–remain in an upright position for at least 30 minutes after taking this medication. Alendronate can be taken daily or as a weekly medicine regimen.
Calcitonin (Miacalcin)
is approved for the treatment of osteoporosis in women who are five years postmenopausal and cannot tolerate estrogen therapy. Studies demonstrate that this medication helps slow bone loss, increases spinal bone density and may relieve fracture pain. It may reduce hip fracture also. Because calcitonin is a protein, it cannot be taken orally as it would be digested before it could work. Instead, it is taken as a nasal spray or (less common) in injection form. Possible side effects include nasal irritation and inflammation, bloody nose, headache and backache. Injectable calcitonin may cause an allergic reaction and flushing of the face and hands, frequent urination, nausea and skin rash.
Raloxifene (Evista),
available in pill form, is a medication approved for the prevention and treatment of osteoporosis in postmenopausal women. Raloxifene has positive estrogen-like effects on bone but not on the breast or lining of the uterus, and may reduce the risk of estrogen-dependent breast cancer by 65 percent over four years. It is from a new class of drugs called selective estrogen receptor modulators (SERMs) that appear to prevent bone loss at the spine, hip and other points in the body. Raloxifene has been shown to reduce the chance of spinal fracture by half in women with osteoporosis, but there are no data confirming that it reduces the risk of any fractures other than those of the spine. Possible side effects include hot flashes, blood clots in the veins (similar to estrogen) and leg cramps. The pill is taken once a day, with or without meals.
Risedronate (Actonel),
another type of bisphosphonate drug, taken in pill form, is a bone-specific medication approved to treat and prevent osteoporosis in postmenopausal women and for prevention and treatment of glucocorticoid-induced osteoporosis in women and men. It has been shown to increase bone mass and reduce the risk of spinal, wrist, hip and other nonspinal fractures in women with osteoporosis. It has also been approved for the prevention and treatment of glucocorticoid-induced osteoporosis and treatment of osteoporosis in men.