Disease Prevention in Women

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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Screening tests are a basic part of prevention medicine. All screening tests are commonly available through your general doctor. Some specialized tests may be available elsewhere. Take an active role and discuss screening tests with your doctor early in life. The following charts are beneficial (generally simple and safe) screening tests that can help detect diseases and conditions before they become harmful.

Osteoporosis is a condition with progressive loss of bone density leading to bone fractures. Estrogen is important in maintaining bone density. When estrogen levels drop after menopause, bone loss accelerates. Thus osteoporosis is most common among postmenopausal women.

Measurement of bone density using dual energy X-ray absorptiometry (DEXA) scan

DEXA bone density scanning can:

• detect osteoporosis before fractures occur
  
  
• predict the risk of future bone fractures
  
  
• Although still controversial, some doctors use bone density to monitor effects of osteoporosis treatments

The National Osteoporosis Foundation guidelines state that all postmenopausal women below age 65 who have risk factors for osteoporosis or medical conditions associated with osteoporosis and all women aged 65 and older should consider bone density testing.

High risk factors for osteoporosis include:

• early menopause or surgical absence of ovaries;
  
  
• family members with osteoporosis and related bone fractures;
  
  
• cigarette smoking and/or heavy alcohol use;
  
  
• over-active thyroid gland (hyperthyroidism), previous or current anorexia nervosa or bulimia;
  
  
• thin stature, light skin;
  
  
• Asian or Northern European descent;
  
  
• any condition associated with poor absorption of calcium or vitamin D;
  
  

• chronic use of oral corticosteroids (such as cortisone and prednisone [Deltasone, Liquid Prep]), excessive thyroid hormone replacement, and phenytoin (Dilantin) or other anti-seizure medications; and
  
  

• problems with missed menstrual periods.

Osteoporosis produces no symptoms until a bone fracture occurs. Bone fracture in osteoporosis can occur with only a minor fall, blow, or even just a twist of the body that ordinarily would not cause an injury.

Prevention and treatment of osteoporosis can decrease the risk of bone fractures.

Prevention measures include:

• quitting smoking and curtailing alcohol intake;
  
  
• performing regular weight-bearing exercises, including walking, dancing, gardening and other physical activities, and (supervised) muscle strengthening exercises;
  
  
• getting adequate calcium and vitamin D intake;
  
  
• medications may be taken to prevent osteoporosis. The most effective medications for osteoporosis that are approved by the FDA are anti-resorptive agents, which prevent bone breakdown. Examples include Others include alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), ibandronate (Boniva), calcitonin (Calcimar), and zoledronate (Reclast); and
  
  
• while hormone therapy containing estrogen has been shown to prevent bone loss, increase bone density, and decrease the risk of fractures, HT has also been associated with health risks. Currently, HT is recommended for women for the treatment of menopausal symptoms only at the lowest effective dose for the short-term.