Only “old ladies” get osteoporosis. Most patients with osteoporosis are postmenopausal women, generally over age 55. In today’s society, that’s hardly considered old! Interestingly, osteoporosis at any age makes its patients appear older than those of the same age with better posture. Contrary to this myth, osteoporosis also affects men (approximately one in five patients with osteoporosis is male), younger women who have had their ovaries removed, younger patients with various diseases from respiratory illnesses to anorexia, patients who take chronic steroids and astronauts.
Little old ladies are supposed to look hunched over. Nonsense!
There’s nothing you can do about osteoporosis once you have it. Once osteoporosis is diagnosed, medications can be started to halt further bone loss and further degeneration. As with any condition, early diagnosis is the key to the most successful outcomes.
Osteoporosis doesn’t kill anyone. Of those with hip fractures from osteoporosis, one in four will die prematurely within one year.
I’ll worry about osteoporosis after menopause. Primary prevention-preventive measures started before the disease begins is the most effective weapon against osteoporosis. This means assuring an adequate calcium intake and doing sufficient weight-bearing exercise in the premenopausal years. It may also mean taking hormone replacement therapy in early menopause or birth control pills in late perimenopause.
My mother didn’t have it; why should I worry about it? While you would be at increased risk if your mother did have it, you can’t bet that if she didn’t have it, you won’t. Chances are, your mother may have had osteoporosis without being diagnosed: the tools we have at our disposal are much more sophisticated than those available even 10 years ago. Chances are also that you will live longer than your mother, thus increasing the odds that you may be affected by osteoporosis. You may also have other risks that your mother didn’t. And finally, half of your genes are from your father.
Women of color aren’t at risk for osteoporosis. This misbelief comes from the common statement that Caucasian and Asian women are at increased risk. African American and Hispanic women are still at risk when they go through menopause, just a little less than other groups.
I always drank milk; I have nothing to worry about. Four eight-ounce glasses of milk per day in childhood and adolescence is worth more than 32 ounces of prevention, but it’s not the only factor. Keep drinking milk, but speak to your physician about other preventive measures you should take and whether you need a bone mass measurement test.
Prevention
Tips to prevent osteoporosis include getting adequate amounts of calcium and Vitamin D in your diet as early as possible; living an active lifestyle with frequent weight bearing exercise (e.g. walking); preventing falls and other accidents; and giving up smoking and heavy drinking. The recommended calcium intake for postmenopausal women is 1,500 mg/day. It is difficult for most women to get this amount of calcium from their diets alone. In fact, the average 44-year-old American woman consumes only 440 mg of calcium per day! As a result, most physicians recommend calcium supplements for the balance. These can be tablets that you swallow (e.g. Caltrate ®, Os-Cal®, or Citracal®), that you chew (e.g. Tums ®), or even the new products that are “disguised” as chocolate-covered candies (for 20 calories each)! This is especially important for women with lactose intolerance, even though there are products such as Lactaid ® to help with the symptoms of this condition. Many women avoid dairy products in fear that they will increase their cholesterol levels or add too many unwanted calories. To address these concerns, look for skim or fat free products (which actually contain higher calcium levels than their fuller fat counterparts). Non-dairy foods which are high in calcium include tofu, broccoli, and calcium-fortified orange juice.
Medications are also available to prevent osteoporosis in women at high risk. These include estrogen replacement therapy and alenronate (see treatment section below) and raloxifene (Evista®), a selective estrogen receptor modulator (SERM). Both estrogen replacement therapy and alendronate reduce fracture risk as well as osteoporosis risk, Raloxifene slows bone loss and may reduce fractures. It should not be confused with estrogen, as they have many different actions. It is considered a good choice of medication for women who cannot or will not take estrogen who are also at high risk for (or who have had) breast cancer; one of its other actions is that it may reduce breast cancer risk.