It is estimated that one in three women over age 50 have osteoporosis. Knowing the risk factors and symptoms of osteoporosis can help women take measures to increase bone density before the effects become devastating.
The risk factors for osteoporosis are divided into two categories: those that cannot be changed such as gender, race, and family history and those that can be changed such as alcohol consumption, smoking, and calcium intake.
Risk Factors That Cannot Be Changed
Female gender: Because women have lighter, thinner bones than men, osteoporosis is much more frequent in women. At age 35, men have 30% more bone mass than women. Bone loss also occurs much more slowly in men than women.
Advancing age, especially the onset of menopause: Before a woman reaches her mid-30s, her body gains more bone than it loses. Around age 35, this process balances out. When a woman reaches menopause (typically around age 50), her body produces less of the female hormone estrogen. Since estrogen helps maintain body density, a decrease in the hormone will result in some bone loss. If bone loss is severe, a woman may experience an increase in bone fractures, loss of height, restricted mobility, or a humped back (also known as a "dowager’s hump"). Women who experience menopause at an early age (age 45 or younger) are at even higher risk because their level of estrogen will be lowered at an earlier age.
Family history: Women whose family members have had osteoporosis are at increased risk for the disease. Body type is often similar among mothers or sisters.
Race: Asian and Caucasian women are at greater risk for osteoporosis since their bone density is 5% to 10% lower than that of African-American women or women or Mediterranean or Aborignal decent. Women with fair skin, freckles, or red or blond hair are also at higher risk.
Build: Women with thin or small frames have a higher risk for bone fractures.
Certain diseases: Women who have anorexia (an eating disorder), celiac disease (an inability to tolerate grain products), diabetes, chronic diarrhea, or kidney or liver diseases are at an increased risk for osteoporosis.
Risk Factors That Can Be Changed
Smoking: Since smoking interferes with the body’s processing of calcium, smokers experience vertebral fractures more frequently than nonsmokers. In addition, women who smoke usually experience menopause one to one and a half years earlier than nonsmokers. Thus, their estrogen deficiency begins sooner than women who do not smoke.
Alcohol consumption: Studies show that consuming two or more alcoholic drinks daily decreases a woman’s rate of calcium absorption, which may lead to bone loss. Alcohol also interferes with vitamin D synthesis-a process that helps bones absorb calcium.
Childlessness: Women who never have children are at higher risk for osteoporosis. During each pregnancy, women experience temporary surges of estrogen that helps protect them from osteoporosis.
Low calcium intake (as an adult or child): Calcium is essential for healthy bones. The Food and Drug Administration (FDA) recommends that women receive 1200 milligrams of calcium per day to maintain bone strength. According to the Physician’s Desk Reference website (PDR), over 75% of American women take in than 800 mg of calcium per day, and one out of four women take it less than 300 mg per day. For women who have already gone through menopause, the FDA recommends 1000mg to1300 mg of calcium per day to help prevent osteoporosis.
Too little exercise: A sedentary lifestyle with little physical activity can lead to osteoporosis. Bones can lose their mass during long periods of inactivity. Exercise helps maintain bone strength and growth. For women with low bone density, exercise may stimulate bone growth.
Weight: Women who are extremely thin are at higher risk for osteoporosis than heavier women because bone mass can benefit from excess fat. Fat tissues help convert other hormones to estrogen, even after menopause, and estrogen stimulates calcium absorption. Also, women who have poor muscle tone are at higher risk for osteoporosis.
Previous broken bone from minor injury: Women who break bones easily are at higher risk for osteoporosis than most women because their bones are not as strong. When a sharp decrease in estrogen occurs at the onset of menopause, these women will be at even greater risk.
Certain medications and steroids: Commonly prescribed steroids to treat asthma and arthritis (such as cortisone and prednisone) and high doses of thyroid hormone increase the chances of osteoporosis. Also, certain medications used to treat seizures (such as phenobarbital and phenytoin (trade name Dilantin) interfere with the body’s ability to absorb calcium.
Symptoms / Indicators of Osteoporosis
Back pain: Vertebrae fractures are the most common bone fractures associated with osteoporosis. An early symptom of the disease is chronic lower back pain. Women may also experience sudden muscle spasms during periods of inactivity. This sudden back pain is caused by the spontaneous collapse of small, weak sections of the spine. The type of back pain associated with osteoporosis is confined to one area of the back and does not usually spread. Women who experience these symptoms should consult an orthopedic specialist. Often, women who develop osteoporosis will begin to experience chronic lower back pain about nine and a half years after their last menstrual period or 13 years after surgical menopause.(1)
Height loss, curving spine: The loss of height indicates the collapse of a spinal vertebra. These collapses typically occur at the weakest point of the spinal column-the spinal curve. Women with osteoporosis may lose two and a half to eight inches in upper body height. Older women should routinely measure their height.
Broken bones: Older women who break bones easily may have osteoporosis. A history of broken bones at a younger age is a high risk factor for the disease.
Chest X-ray showing osteopenia: Osteopenia is a condition in which a woman’s bone mass is lower than normal. A decrease in bone mass will affect the strength of bones, causing them to break more easily.
Tooth loss: Tooth loss around age 50 and the thinning of bones that support the teeth (periodontal bones) may indicate osteoporosis. Women may prevent tooth loss by practicing good oral hygiene throughout their lifetime.