Osteoporosis literally means 'porous bone', a condition
in which the bone becomes thinner and more fragile. Most bones
are hollow inside and their strength comes from an outer solid
cylinder lined by a more 'spongy ' type of bone that looks
like a honeycomb. It is this (trabecular) bone that becomes
much thinner in osteoporosis making it much more likely that
the bone will break in a fall.
All bones are constantly remodelled
(bone is continually broken down and replaced), but after
the age of 35 more bone is lost than is replaced so the skeleton
becomes very gradually thinner and weaker. The sex hormone
oestrogen is an important factor in making bone and after
the menopause the loss of calcium from the skeleton accelerates.
A similar process may happen in men, because the sex hormone
testosterone acts on the skeleton in a similar way to oestrogen,
however because men have a larger, heavier skeleton the effect
is less pronounced. Even so about a quarter of the fractures
associated with osteoporosis occur in men. Osteoporosis also
depends on genetic factors, diet, exercise and lifestyle.
What are the symptoms?
There are no specific symptoms – osteoporosis is usually
first identified when a fracture occurs – often as a
result of a relatively minor fall. Fractures of the wrist,
hip and spine are the most common.
How can osteoporosis be diagnosed?
Diagnosis is by bone density measurements – a process
similar to having an Xray. The measurement technique is called
a DEXA scan (dual energy x-ray absorptiometry). The measurement
is given as a T score. In women osteoporosis is defined
as having a T score of less than -2.5.
How is it treated?
Treatment depends on the type of fracture and the medical
history. Bisphosphonate drugs are commonly used but a range
of other treatments are available. Advice on diet and lifestyle
is also important.
Questions patients ask
I have a family history of osteoporosis. Can I do
anything to prevent it happening to me?
There are some lifestyle changes which will help:
Keep your daily intake of calcium to 800 milligrams (mg)
Increase your daily intake of Vitamin D - take supplements
of 10–20 micrograms (µg) of Vitamin D if you
are over 65, or do not spend time outdoors, or cover up.
Reduce coffee consumption (this affects the absorption
of Vitamin D)
Take up weight-bearing exercise such as walking, jogging,
Avoid excessive alcohol consumption
National Osteoporosis Foundation
National Institute for