The Facts of Life: Examining Reproductive Health

Health Concerns for Middle-age and Up

Osteoporosis

• A thin, small-boned frame
• Broken bones or stooped posture in older family members, especially women
• Early estrogen deficiency in women who experience menopause before the age of 45, either naturally or resulting from surgical removal of the ovaries.
• Estrogen deficiency as a result of amenorrhea (the abnormal absence of menstruation)
• Advanced age
• A diet low in calcium
• An inactive lifestyle
• Caucasian and Asian women are at highest risk; African American and Hispanic woman are at a lower but significant risk
• Cigarette smoking
• Excessive use of alcohol
• Prolonged use of certain medications including glucocorticoids, a group of anti-inflammatory medications used to treat conditions such as asthma, arthritis and certain cancers; excessive thyroid hormone and some anti-seizuremedications

Courtesy of the National Osteoporosis Foundation

43. Normal bone structure

44. Depleted structure of an osteoporotic bone

Facts About Osteoporosis

• More than 55 million Americans, mostly women, are at high risk of developing osteoporosis; yet a Gallup survey of women ages 45 to 75 indicates that three out of four women have never spoken to their doctor about the disease.
• Osteoporosis leads to 1.5 million fractures each year.
• One in three women older than 50 years of age will suffer a vertebral fracture. Vertebral fractures can cause the spine to collapse and lead to a loss of height and stooped posture.
• A woman's risk of developing a hip fracture is equal to her combined risk of developing breast, uterine and ovarian cancer.
• More than 300,000 hip fractures occur every year because of osteoporosis.
• Women are five times more likely to suffer from osteoporosis than men due to the loss of estrogen at menopause.

Courtesy of the National Osteoporosis Foundation

Osteoporosis, "The Silent Thief"
Osteoporosis is one of the most serious health problems facing women today. The disease affects more than 55 million Americans, 80% of which are women. By the age of 50, one in every two women will experience an osteoporotic fracture.

Everyone experiences some bone loss by the age of 35. It is a characteristic of aging. However, the amount of bone loss at this time is very small. Osteoporosis, on the other hand, is characterized by the loss of bone and poor bone quality which increases the risk for bone fractures.

Approximately 1.5 million fractures per year have been attributed to the disease. Although the disease affects the entire skeletal system, fractures occur typically at the hip, spine, and wrist. After early or normal menopause, bone loss accelerates, and a woman's need for calcium increases to approximately 1,500 mg per day. Before menopause, a woman is protected against bone loss by the hormone estrogen, manufactured in the ovaries. Because the ovaries stop producing estrogen after menopause, women can lose up to 20% of their bone mass in the first five to seven years following menopause. Once bone density is lost, it cannot be replaced. The disease can cause suffering, permanent disability and disfigurement.

Estrogen replacement therapy (ERT) is often recommended for women who are at high risk for osteoporosis. This is especially true for women who have had their ovaries removed before the age of 50. ERT is also recommended to women who have experienced natural menopause and have the following osteoporosis risk factors: a blood relative with osteoporosis, or below-normal bone mass for their age. Combined with an intake of 1,000 mg of calcium a day, ERT may prevent or arrest bone loss. However, there are risks associated with use of ERT (see section on heart disease) and it may not be appropriate for everyone.