WOMEN: PREVENTING OSTEOPOROSIS. OESTROGEN AND OTHER RISK FACTORS
Oestrogen
Lack of oestrogen is the most important factor in the development of osteoporosis in women. Oestrogen decreases bone breakdown, prevents loss of calcium via the kidneys and improves absorption of calcium from the bowel. Even with enough exercise and calcium, women who lack oestrogen before or after the menopause will lose more bone more rapidly that those who don’t.
Health authorities now recognize the importance of oestrogen replacement in maintaining older women’s health, especially in the prevention of osteoporosis. However, some women don’t want to use HRT, and it would be overkill to recommend that all women take oestrogen to prevent fractures when two out of three postmenopausal women won’t suffer the symptoms of osteoporosis. It’s generally possible to predict whether a woman is at increased risk.
Techniques have been devised to measure bone density and the degree of bone loss from osteoporosis. These tests may be used to identify early those at higher risk of fractures in later life so that vigorous steps can be taken to prevent further bone loss. Your doctor might suggest such tests if you seem to be at high risk, though many doctors skip the tests and encourage all middle-aged women to begin and maintain a routine that will prevent them from ever suffering disability from osteoporosis. This means having enough exercise and calcium, and hormone replacement if needed.
For women who can’t take oestrogen, other medications may be helpful. Calcitonin (a hormone produced in the thyroid gland) and calcitriol (a type of vitamin D) have been used with some success in the prevention and treatment of osteoporosis, but they are not suitable for everyone and should be used only under supervision of a specialist in osteoporosis. Anabolic steroids seem to relieve the symptoms of established osteoporosis and slow down or halt the process, but also may have unwanted side-effects in some cases.
Other risk factors
Other factors can influence the risk of fractures from osteoporosis.
Body build
Thin women are at greater risk than plump women. Body fat can convert hormones from the adrenal gland into oestrogen: not as much as the ovaries produce before menopause, but enough to slow down bone loss. Also, the bones of heavier women are more stimulated by the greater weight they support. Short women are at greater risk than tall women, because they have less bone mass and so lose relatively more bone as they age.
Family history
Our genes determine our body shape and height, and family habits of diet and exercise may also be important factors in the development of osteoporosis.
Drugs and smoking
Certain drugs promote bone loss, mi through their effects on body calcium. These are alcohol, some diuretic anticonvulsants, thyroid hormone, cortisone and tetracycline antibiotics. Women who are prescribed these drugs for a long time will have been warned by their doctors that they may need more calcium.
Cigarette smoking encourages bone to by increasing the rate of oestrogen breakdown in the body and perhaps the rate of calcium loss in urine.
Amenorrhoea
Women who’ve had long episodes amenorrhoea between puberty and menopause are more likely to begin postmenopausal years with reduced bone strength.
Until recently one in three women coil expect to suffer a fracture from osteoporosis if they lived beyond 65 years. Now we can help prevent osteoporosis from casing disability by maintaining healthy bones before menopause, and by continuing adequate exercise, taking enough calcium and using HRT if needed, after menopause. If you’re around the age of 50, discuss these measures with your doctor.
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Categories: Women's Health | Tags: Women’s Health
