The problems of menopause -2

What are the symptoms of osteoporosis?
This disorder of the skeleton weakens the bone leading to an increase in the risk of breaking bones (bone fracture). Normal bone is composed of protein, collagen, and calcium.
Bones that are affected by osteoporosis can fracture with only a minor fall or injury that normally would not cause a bone fracture.
The fracture can be either in the form of cracking (as in a hip fracture), or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, and wrists are common areas of osteoporosis-related bone fractures, although osteoporosis-related fractures can also occur in almost any skeletal bone area.
The osteoporosis condition can operate silently for decades, because osteoporosis doesn't cause symptoms unless bone fractures.
Some osteoporosis fractures may escape detection until years later. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture.

Then the symptoms are related to the location of the fractures:
  • Symptoms of Osteoporosis
  • Fractures of the spine (vertebra):
    Can cause severe "band-like" pain that radiates around from the back to the side of the body. Over the years, repeated spine fractures can cause chronic lower back pain as well as loss of height or curving of the spine, which gives the individual a hunched-back appearance often called a "dowager hump."
    A fracture that occurs during the course of normal activity is called a minimal trauma fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

Hip fractures:
typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial accidents. Hip fractures may also be difficult to heal after surgical repair because of poor bone quality.

How to prevent the problems of osteoporosis?
  • summary pevention Chart
  • Goals should include prevention of both the underlying disorder (the disease) and its effects (osteoporotic fractures).
    Secondary osteoporoses are managed by eliminating the underlying disorder. To prevent primary osteoporosis, good health-related behavior during childhood and young adulthood has been suggested as the most important factor.
Such behavior includes:
  • Avoiding cigarette smoking
  • Excess alcohol intake
  • Maintaining a normal body weight
  • Maintaining optimal dietary intake of calcium: It has been suggested that the recommended daily allowance (RDA) for calcium in the postmenopausal period and the recommended intake of vitamin D in the aged should be increased.

At menopause, the possibility of estrogen replacement therapy should be considered for women who are at high risk for osteoporosis. Fracture prevention should be a lifelong effort. During childhood and the premenopausal years, a maximal peak bone mass should be developed through weight-bearing exercise. Exercise to improve coordination and flexibility and to maintain good posture is also useful.

What are the consequences of osteoporosis?
Osteoporosis bone fractures are responsible for considerable pain, decreased quality of life, lost workdays, and disability. Up to 30% of patients suffering a hip fracture will require long term nursing home care. Elderly patients can further develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism) due to prolonged bed rest after a hip fracture. Some 20% of women with a hip fracture will die in the subsequent year as an indirect result of the fracture. In addition, once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years). About 20% of postmenopausal women who experience a vertebral fracture will suffer a new vertebral fracture of bone in the following year.

Risk factors for developing osteoporosis:
  • Female gender
  • Caucasian or Asian race
  • Thin and small body frames
  • Family history of osteoporosis(for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
  • Personal history of fracture as an adult
  • Cigarette smoking
  • Excessive alcohol consumption
  • Lack of exercise Diet low in calcium
  • Poor nutrition and poor general health
  • Malabsorption (nutrients are not properly absorbed from the gastrointestinal system) from conditions such as celiac sprue
  • Low estrogen levels (such as occur in menopause or with early surgical removal of both ovaries)
  • Chemotherapy can cause early menopause due to its toxic effects on the ovaries
  • Amenorrhea (loss of the menstrual period) in young women also causes low estrogen and osteoporosis; Amenorrhea can occur in women who undergo extremely vigorous training and in women with very low body fat (example:
    Anorexia nervosa'Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight.'
    )
  • Chronic inflammation: due to diseases (such as rheumatoid arthritis and chronic liver diseases)
  • Immobility: such as after a stroke, or from any condition that interferes with walking
  • Hyperthyroidism'A condition wherein too much thyroid hormone is produced by the thyroid gland (as in Grave disease) or is caused by taking too much thyroid hormone medication'

  • Hyperparathyroidism'Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH).'
    ,excessive parathyroid hormone causes too much calcium to be removed from the bone, which can lead to osteoporosis
  • Vitamin D deficiency: vitamin D helps the body absorb calcium. When vitamin D is lacking, the body cannot absorb adequate amounts of calcium to prevent osteoporosis.  vitamin D deficiency can result from lack of intestinal absorption of the vitamin such as occurs in celiac sprue and primary biliary cirrhosis
  • Certain medications can cause osteoporosis. These include long-term use of heparin (a blood thinner), anti-seizure medications phenytoin and Phenobarbital, and long term use of oral corticosteroids.

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