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Osteoporosis
Osteoporosismeansboneswithholes.Boneslosetheirstrengthanddensity,becomefragileand break(fracture)moreeasilybecauseofcalciumloss.Breaksaremostcommoninthespine,hip andwristandoftenoccurafteronlyaminorfallorknock.Osteoporosisparticularlyaffectswomen intheirmiddleandlateryears,althoughsomemenarealsoaffected. Mostpeopleshownosignsofdevelopingosteoporosisuntilafractureoccurs.Bothmenand womencantakestepsfromayoungagetoavoiddevelopingtheconditioninlaterlife.Reduceyour riskoffracturesbytakingstepstopreventandtreatosteoporosis(orbrittlebones)andavoidfalls whereverpossible.ActivityandahealthydietrichincalciumandvitaminDarebothimportant. Osteoporosis and bone growth Boneisformedbyspecialisedcells.Liketherestofthebody,boneisconstantlybeingbrokendown andrenewed.Itislivingtissuethatneedsexercisetogainstrength,justlikemuscle.Intheearly yearsoflife,moreboneismadethanisbrokendown,resultinginbonegrowth.Bytheendofyour teens,bonegrowthhasbeencompletedandpeakbonemassisachieved. Sexhormones,suchasoestrogenandtestosterone,haveafundamentalroleinmaintainingbone strengthinmenandwomen.Thefallinoestrogenbloodlevelsthatoccursduringmenopause resultsinacceleratedboneloss.Duringthefirstfiveyearsaftermenopause,theaveragewoman losesupto10percentofhertotalbodybone. Fracturesofthespinecausedbyosteoporosiscanleadtolossofheight,painandchangesin posturesuchastheDowagershump.Thishumpiscausedwhenspinalfracturesarecompressed duetotheforceofgravity,resultinginanabnormalbendingofthespine(kyphosis). Symptoms Osteoporosiscausesnospecificpainorsymptoms.However,itdoesincreasetheriskofseriousor debilitatingfractures.Ifyouthinkyoumaybeatriskofdevelopingosteoporosis,seeyourdoctor. Risk factors for osteoporosis Severalfactorscanplaceapersonatriskofosteoporosis.Riskfactorsinclude: Familyhistoryofosteoporosis(mother,sisterorgrandmother) Inadequateamountsofdietarycalcium LowvitaminDlevels Cigarettesmoking Alcoholintakeofmorethantwostandarddrinksperday Caffeineintakeofmorethanthreecupsoftea,coffeeorequivalentperday Lackofphysicalactivity Earlymenopausebeforetheageof45 Lossofmenstrualperiodifitisassociatedwithreducedproductionofoestrogen,whichis vitalforhealthybones(themenstrualcyclecanceasefollowingexcessivedietingand exercise) Long-termuseofmedicationssuchascorticosteroidsforrheumatoidarthritisandasthma.

Ima ge des crip

Someconditionsplacepeopleatahigherriskofosteoporosis.Theseconditionsinclude: Thyroiddiseaseoranoveractivethyroidgland Rheumatoidarthritis Chronicliverandkidneydisease Conditionsthataffectthebodysabilitytoabsorbnutrients,suchasCrohnsdisease, coeliacdiseaseandotherinflammatorybowelconditions.

Preventing osteoporosis

Osteoporosis

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Bothmenandwomencantakestepsfromayoungagetopreventosteoporosisbymakingsure thatthey: Haveahealthyandvarieddietwithplentyoffreshfruit,vegetablesandwholegrains Eatcalciumrichfoods AbsorbenoughVitaminD Avoidsmoking Limitalcoholconsumption Limitcaffeine Doregularweightbearingandstrengthtrainingactivities.

A varied and calcium rich diet is the key Weneedcalciumtobuildandmaintainstrongandhealthybones,helpourmusclesworkand supportournervoussystem.Goodsourcesofcalciuminclude: Dairy foodslowfatvarietiesareavailabletoreducetheriskofweightgainorraised cholesterollevels Canned fish with edible bonesforexample,sardines.

Theminimumrecommendeddailyintakeofdietarycalciumis: Infants(under12months)210270mgcalciumperday Children(overfouryears)7001,000mgcalciumperday Adolescents1,300mgcalciumperday Womenunder50andmenunder701,000mgcalciumperday Postmenopausalwomenandmenover701,300mgcalciumperday.

Adequate vitamin D VitaminDlevelsareincreasedwithsunexposure.Peoplewhoarehouseboundorwhodresswith mostoftheirbodycoveredareatriskofvitaminDdeficiency.ThemajorityofAustralianwomen haveinadequatelevelsofvitaminDduringwintermonths.Allthatisneededis1020minutesof sunexposuretothearmsandfacedaily,withoutsunscreenandnotthroughglass.Sunexposureis safestbefore11amorafter3pm. Avoid smoking Evidencehasshownthatsmokershavealowerbonedensity.Nicotineisknowntobetoxictobone cells. Limit alcohol intake Excessivealcoholconsumptionisassociatedwiththedevelopmentofosteoporosis.Restrictyour alcoholintaketonomorethantwostandarddrinksonanyonedayforbothmenandwomento reduceyourrisk.Everyoneshouldhaveatleasttwoalcohol-freedayseachweek. Reduce caffeine intake Alargeamountofcaffeine(morethantwotothreecupsperdayofcola,teaorcoffee)hasalso beenassociatedwithanincreasedriskofosteoporosis. Do regular weight bearing and strength training activities Youshouldexerciseatleast30minutesthreetofourtimesaweektomaintainhealthybones. Recommendedactivitiesare: Walking Jogging Tennis Dancing Usingweights.

Thishelpsmaintainbonestrengthandbalancesofallsarereduced. Diagnosis ThemostreliablewaytodiagnoseosteoporosisistomeasurebonedensityusingaDEXAscan. Thisisdonewithx-raytechnologythatinvolvesminimalradiation,isaccurateandcanbeusedto followuptreatment.

Osteoporosis

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Ultrasoundtestsareavailableatmanypharmaciesandinvolveanultrasoundmeasurementofthe heel.ThesetestsarenotasaccurateinassessingforosteoporosisasaDEXAstudyandarenot recommendedbydoctors. Its never too late for treatment Ifyouhaveosteoporosis,itisnevertoolatetoseektreatment.Treatmentcanhaltbonelossand significantlyreducetheriskoffractures.Itisimportantthatyourdoctorexcludesothermedical conditionsthatcancauseosteoporosis,includingvitaminDdeficiency. Medicationsandtreatmentsareavailabletostrengthenbonesandpreventfracturesbyslowing downboneloss.Theymayimprovebonedensityinwomenwithosteoporosisafterthemenopause. Availablemedicaltreatmentsinclude: Bisphosphonatessuchasalendronate,risedronateandzolindrinicacid,whichcanbe combinedwithvitaminDandcalcium Strontium ranelatesoldinAustraliaunderthebrandnameProtos Selective oestrogen receptor modulators (SERMs)intheformofraloxifene Vitamin D derivatives and calcium supplements Hormone replacement therapy (HRT)short-termuseofoestrogenandprogestogen atmenopause.

Otherpotentialtherapiesthatmaybeusedastreatmentincludeparathyroidhormone. Hormone replacement therapy Alltreatmentsforosteoporosisaimtopreventfractures.Oestrogenreplacementatmenopause preventsbonelossandfractures,buttheeffectlastsonlyaslongasoestrogenisused. Oestrogencanbeisusedtopreventfracturesmainlyforyoungerwomenwithpremature menopause.Thisisbecausemostfracturesdonotoccuruntilaftertheageof65andlong-term oestrogenuseisnotrecommended. Falls are a risk for people with osteoporosis Forpeoplewithosteoporosis,evenminortraumasuchascoughing,knocksonthelimbsand simplefallscanleadtofractures.Fallsareaparticularproblemintheelderlyastheyareoften morelikelytoresultinfractures,particularlyofthehip.Anyfractureoccurringfromminimal traumashouldbeinvestigatedasitmayindicateunderlyingosteoporosis. Thereareseveralwaystoreduceyourriskoffalls.Itmaybenecessarytoseeaphysiotherapist and/oroccupationaltherapisttoprovideassistancewithwalkingaidesandensureyourhome environmentissafe.Talkwithyourdoctororcontactyourcommunityhealthcentretofindthe servicesyouneed. Where to get help TheJeanHailesMedicalCentreforWomenTel.(03)95627555 Yourdoctor Localcommunityhealthservice Specialisedwomenshealthclinic AnAccreditedPractisingDietitian,contacttheDietitiansAssociationofAustralia

Things to remember

Osteoporosisoccurswhenboneslosetheirdensityandstrength. Ahealthylifestylethroughoutlife(adequatedietarycalciumandregularphysicalactivity) canhelppreventosteoporosis. Oestrogenreplacementhelpsmaintainbonedensityinwomenwithprematuremenopause.

This page has been produced in consultation with, and approved by:

JeanHailesFoundationforWomen'sHealth

Osteoporosis

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Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Osteoporosis

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