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- Patient Comments: Disease Prevention in Women - Osteoporosis Prevention
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- Disease prevention in women overview
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Disease prevention in women overview
Screening tests are a basic part of preventitive medicine. All screening tests are commonly available through your primary care physician. Some specialized tests may be available only through specialists. Take an active role and discuss screening tests with your doctor early in life. The following examinations represent beneficial (generally simple and safe) screening tests that can help detect diseases and conditions before they become well-established and harmful.
Osteoporosis is a condition characterized by 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 more 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
- be used to monitor the efficacy of treatment regimens to combat osteoporosis.
Who to test and how often
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 spontaneous menopause or surgical menopause secondary to removal of the ovaries;
- family members with osteoporosis and related bone fractures;
- cigarette smoking and/or heavy alcohol abuse;
- over-active thyroid gland (hyperthyroidism);
- previous or current anorexia nervosa or bulimia;
- thin body habitus;
- light skin;
- Asian or Northern European descent;
- conditions associated with poor absorption of calcium or vitamin D;
- chronic use of oral corticosteroids (such ascortisone and prednisone [Deltasone, Liquid Prep]), excessive thyroid hormone replacement, and phenytoin (Dilantin) or other anti-seizure medications; and
- problems with missed menstrual periods.
Benefits of early detection
Osteoporosis produces no symptoms until a bone fracture occurs. Bone fracture secondary to osteoporosis can occur with only a minor fall, blow, or even just a twist of the body that normally would not cause an injury.
Prevention and treatment of osteoporosis can decrease the risk of bone fractures.
Preventative measures include:
- quitting smoking;
- curtailing alcohol intake;
- performing regular weight-bearing exercises, including walking, dancing, gardening and other physical activities;
- 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 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, hormone therapy is recommended for women for the treatment of menopausal symptoms. The lowest effective doseage of hormone therapy should be used, and it should only be continued until symptoms have resolved.