Boning Up: Good News About Osteoporosis
Most health-conscious women are aware of the perils of osteoporosis, or weakening of the bone. Many of us have heard the sobering statistics: Osteoporosis is a major public health threat for more than 28 million Americans, 80 percent of them women. One in two women over 50 will have an osteoporosis related fracture in her lifetime.
But Women’s Care physician Doug Austin, M.D., offers some good news about osteoporosis. "Technology has given us new tools to detect and predict osteoporosis, and new therapies are available and easier to take."
Screening for osteoporosis is non-invasive, relatively inexpensive and readily available. A bone mineral density (BMD) test is the only way to diagnose osteoporosis and determine a patient’s risk for future fractures. Since osteoporosis can develop undetected for decades until a fracture occurs, early diagnosis is key.
"We recommend that all women have their bone density measured as menopause approaches," says Dr. Austin. "Based on the initial result, follow-up tests may be necessary at one to three year intervals."
Although there’s no cure for osteoporosis, several medications have been approved by the Food and Drug Administration for prevention and/or treatment. Each of these medications slows or stops bone loss, increases bone density and reduces risk of fracture.
The major classes of drugs for osteoporosis treatment are the following:
Prevent Osteoporosis
But Women’s Care physician Doug Austin, M.D., offers some good news about osteoporosis. "Technology has given us new tools to detect and predict osteoporosis, and new therapies are available and easier to take."
Screening for osteoporosis is non-invasive, relatively inexpensive and readily available. A bone mineral density (BMD) test is the only way to diagnose osteoporosis and determine a patient’s risk for future fractures. Since osteoporosis can develop undetected for decades until a fracture occurs, early diagnosis is key.
"We recommend that all women have their bone density measured as menopause approaches," says Dr. Austin. "Based on the initial result, follow-up tests may be necessary at one to three year intervals."
Although there’s no cure for osteoporosis, several medications have been approved by the Food and Drug Administration for prevention and/or treatment. Each of these medications slows or stops bone loss, increases bone density and reduces risk of fracture.
The major classes of drugs for osteoporosis treatment are the following:
- Estrogen. Estrogen has been shown to reduce bone loss, increase bone density, and reduce the risk of hip and spinal fractures in postmenopausal women. The issue of a relationship between breast cancer and estrogen has not yet been fully determined, but estrogen appears to increase breast cancer risk modestly, if at all.
So-called ‘designer estrogens,’ known as selective estrogen receptor modulators (SERMs), appear to prevent bone loss and reduce the risk of spine fractures. Unlike estrogens, SERMs don’t appear to stimulate breast or uterine tissue, which make them a good choice for women at risk of breast or uterine cancer. Raloxifene (Evista) is the most widelyused drug in this class.
- Biophosphonates prevent or slow bone loss. The most widely prescribed drug in this class, Fosamax, is approved for both prevention and treatment of osteoporosis. Recent clinical trials have shown that one weekly dose of Fosamax—seven times the daily dose—is as effective as taking the drug daily. This is much more convenient dosage, since Fosamax should be taken first thing in the morning a half hour before the first food or beverage of the day. Also, individuals taking Fosamax are advised to remain upright for at least a half hour after taking the drug.
- Calcitonin is a naturally occurring hormone. When given to patients with osteoporosis, it slows bone loss and increases spinal bone density. While calcitonin reduces the risk of spinal fractures, it doesn’t appear to have a significant effect on non-vertebral fractures. Salmon-derived calcitonin, known by the brand name Miacalcin, is available as an injection or a nasal spray.
Prevent Osteoporosis
- Eat a balanced diet rich in calcium and vitamin D
- Maintain weight-bearing exercise
- Quit smoking
- Drink alcohol, soda and caffeine only in moderation
- Get bone density testing and medications when appropriate
