One of the things that makes osteoporosis so dangerous is its silence. The disease gradually weakens bones over time, often without causing symptoms; sometimes until a simple fall, awkward step or even lifting something heavy leads to a fracture.
An estimated 10 million Americans have osteoporosis, and about 80 percent of them are women. As we age, especially after menopause for women, the minerals in bones can become less dense, to the point that even a low‑impact injury can cause a break called a fragility fracture.
Our goal is to prevent that at Montage Health. Osteoporosis is a silent disease. We don’t know if somebody has low bone density unless they start sustaining fragility fractures as they get older.
Listening Before Your Bones Speak
Fortunately, osteoporosis doesn’t have to stay silent. A bone‑density test uses low‑dose X‑rays to identify bone‑density decreases before a fracture occurs. The scan can determine fracture risk, diagnose osteoporosis and provide a baseline for tracking changes over time.
The Bone Health and Osteoporosis Foundation recommends bone‑density testing for:
- Women ages 65 or older and men ages 70 or older
- People who break a bone after age 50
- Postmenopausal women with risk factors
- Men ages 50–69 with risk factors
Who’s at Risk?
Bone density usually remains stable until menopause, when declining estrogen levels can accelerate bone loss by 2 to 4 percent each year. Men can also develop osteoporosis, but they rarely experience a dramatic decrease in bone density as they age unless they take certain medications, such as prednisone or other steroids.
If a man is being treated for prostate cancer and he’s taking medications that lower his testosterone, he may be at increased risk of developing osteoporosis.
Risk factors include family history of osteoporosis, being small and thin, broken bones or height loss. Other causes may include:
- Low testosterone and hormone imbalances
- Having a diet low in calcium and vitamin D
- Lack of exercise, especially weight-bearing activities
- Smoking and excessive alcohol use
- Certain medical conditions and medications
Adolescents with eating disorders like bulimia or anorexia risk never developing peak bone mass and might be more prone to developing osteoporosis later in life.
Treatments
The good news? Osteoporosis can often be prevented, slowed or treated.
If a woman is experiencing significant hot flashes or other menopause‑related symptoms, she might want to consider hormone therapy to prevent or delay further bone loss.
Supplements like calcium or vitamin D can also be helpful, but I caution against overusing calcium because of increased risk for developing kidney stones or calcification of coronary arteries.
If someone has fragile bones, we can try medications like bisphosphonates or Prolia®, which can maintain or improve bone density by slowing the rate at which bone breaks down. We can also try Evenity®, which can help build new bone to improve bone density and reduce fracture risk.
To learn about women’s health at Montage Health, visit montagehealth.org/womenshealth.
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