Women's Services: FAQs

Understanding Osteoporosis and Bone Densitometry Testing

What is osteoporosis?

Many women develop osteoporosis, a potentially crippling disease, without being diagnosed or treated.

As we age, our bone mass declines faster than new bone can form. This can result in osteoporosis, or “porous bones,” a potentially crippling disease that makes bones weak and susceptible to fractures. Osteoporosis can affect men and women of any age, but occurs mostly in women after menopause. It is called the “silent disease” because loss of bone mass has no symptoms and usually causes no pain until a bone fractures (breaks). The hip, spine, and wrist bones are the ones most affected by osteoporosis. Hip fractures result in disability and loss of mobility and independence. Spinal fractures cause a loss of height, severe back pain, and curving of the shoulders and spine.

Osteoporosis & Women

Eighty percent of those affected by osteoporosis are women. Women are more likely to develop osteoporosis because they have less bone tissue than men. At menopause, women rapidly lose more bone mass as their estrogen levels decline. Osteoporosis is a major health issue for women. It is estimated that 50 percent of all women will have an osteoporosis-related fracture in their lifetime — greater than a woman’s combined risk of breast, uterine, and ovarian cancer.

What are the risk factors?

The cause of osteoporosis is unknown, but a number of risk factors contribute to the development of bone loss, including:

• Being Female — Almost half of all women over 50 and almost 90 percent of women over 75 have osteoporosis.
• Menopausal and Postmenopausal Women (including early or surgically induced menopause) are at greatest risk because of loss of estrogen which helps maintain bone strength.
• Age — Your risk increases as you age.
• Ethnicity — People of Asian or Caucasian descent have a higher risk for osteoporosis.
• Bone Structure — Small-boned and thin women are at greater risk.
• Dietary Factors — Calcium and Vitamin D deficiencies in your diet contribute to osteoporosis.
• Cigarettes and Coffee — Smoking or drinking more than two cups of coffee a day is associated with reduced bone density.
• Family History of Osteoporosis — Several studies have strongly suggested that genetic factors help determine bone density.
• Medications — Some medications, if taken for a long time, can contribute to bone loss.

Prevention & Treatment

Although there is no cure for osteoporosis, it can be prevented and treated. Many risk factors such as poor diet, lack of exercise, and smoking can be avoided. It is never too late to begin taking steps to prevent osteoporosis or to slow or stop its progress, including:

• Diet — Women over the age of 50 need at least 1,200 milligrams of calcium with vitamin D every day. The best source of dietary calcium is from milk fortified with vitamin D. Vitamin D is an essential companion to calcium in maintaining strong bones. Eat well and take calcium supplements with vitamin D as recommended by your healthcare provider.
• Exercise — Regular exercise is important in maintaining bone mass and increasing strength. Physical activities that help keep bones strong are weight-bearing exercises like walking and bicycling, resistance exercise such as weight training, and non-weight bearing exercises such as swimming.
• Smoking — Women who smoke, particularly after menopause, have a significantly greater chance of spine and hip fractures. The risk for osteoporosis from smoking appears to diminish after quitting.
• Medications — Various medications such as hormone replacement therapy can be effective in preventing bone loss and reducing the risk of hip and spine fractures in postmenopausal women. Other medications are available for women who cannot or choose not to take estrogen.

Osteoporosis usually does not have any symptoms and is not recognized until a bone fracture occurs. At least 25 percent of bone loss has to occur before osteoporosis can be diagnosed from a routine X-ray. Procedures known as single- or dual-energy x-ray absorptiometry are the most accurate measures of overall bone loss.

• Single X-ray absorptiometry is used to measure bone density in the forearm and heel, but is not effective in showing the bone density of the hip or spine.
• Dual X-ray absorptiometry (Dexa Scan) provides the ability either to measure total-body bone density or assess bone density at selected areas such as the spine or hip.

Bone Densitometry Testing

Bone Densitometry is a safe, simple, and painless test that can diagnose osteoporosis and monitor your rate of bone loss and response to therapy. A specialized X-ray detector scans your hip, spine, and sometimes your forearm, and then calculates the density of your bones. The results are compared to a database of other patients of similar age and sex and to a database of young, normal bone density values. Bone Densitometry testing involves no injections or disrobing and takes only minutes to complete. A full report is given to your physician.

Who should have a Bone Densitometry test?

• All women 65 and older
• Postmenopausal women with one or more risk factors
• All postmenopausal women who have a fracture

What are the risks?

There can be some risks involved with certain diagnostic procedures, and in most cases they are relatively minor. Please ask your doctor to discuss the risks and benefits so that you are fully informed about any tests you may have.

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