Effectively counter osteoporosis
Osteoporosis is an insidious process; the bones become more and more fragile. At the end of the process fractures can occur all of a sudden. The result is acute pain and limited mobility. Statistics have shown that every third woman suffers from bone fractures caused by osteoporosis.
Beginning at the age of 30 the bones become more fragile at a rate of 1% per year. Obviously, that is genetically determined. That is also true for men. For women the reduction of estrogens plays an additional role as it supports the deterioration of the bones. The rate can increase to up to 4% per year. At the same time an estrogen deficiency symptom is a limited production of vitamin D and a calcium resorption. Therefore, the reconstruction of the bones is limited as well.
We differentiate between three levels of osteoporosis depending of the severity.
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.
Many factors have an influence on osteoporosis. We will talk them through when I take your medical history. Among those influential factors is your family history, spontaneous bone fractures after the age of 45 (not as a result of an accident), breastfeeding, medications, lack of exercise, being underweight, smoking, alcohol addiction, unbalanced diet and specific diseases.
Osteoporosis is suspected when the patient has lost four or more centimeters of her original total height. Other indicators might be a change in the specific shape of the back and back pain.
Here we do a dual energy x-ray absorbtiometry (DXA) of the spinal column and of the hips.
That examination can detect any level of osteoporosis even before symptoms occur. Furthermore, the rate of the bones’ density loss can be determined, through that one can even determine your risk of osteoporosis. Moreover, one can predict the effectiveness of various therapies. If pain occurs and there is a suspicion of a bone fracture, an x-ray is necessary and further examinations.
A hormonal replacement therapy is an option for the prevention of osteoporosis. The target groups are women in the menopause. Especially women with an increased risk should undergo therapy. During the menopause the bones get more and more fragile. Hormonal therapy can diminish that effect. Through taking additional estrogens the resorption of calcium is improved. That results in an increase of the reconstruction of the bones. Furthermore, the activity of the osteoclasts is minimized. The osteoclasts reduce the bones.
The WHI-study proved the positive effect of the estrogens. Nevertheless you have to weigh up the advantages and disadvantages very carefully for yourself.
THE (SIDE-)EFFECT
Hormone therapy can cause an increased risk of thrombosis, heart attacks and strokes, especially in the first two years. That is a result of the activation of the coagulation system. This is important especially for women with genetic or other risks for thrombosis, such as obesity or smoking.
When we start hormone therapy very early after menopause we discuss a protection of the vessels, because estrogens can prevent the loss of elasticity which normally comes with ageing .
LONG-TERM THERAPY
A course of treatment lasting five years and longer slightly increases your risk for breast cancer. Especially when the patient’s or family history is suspicious, one should be cautious about hormonal therapy.
But in addition to prevention of osteoporosis we treat a lot of vegetative symptoms that may indicate an estrogen deficiency are, for example, depression, panic attacks, insomnia, hot flashes and strong sweating.
If a risk of osteoporosis exists, estrogen-gestagen therapy can be a good idea as long as the contra-indications are not predominant.
ESTROGEN DEFICIENCY SYMPTOMS OF YOUNG WOMEN
Especially when it concerns young women an estrogen deficiency should be treated through hormonal therapy. The result of the deficiency would be a reduction of the “peak bone mass” and therefore an increase of the risk of osteoporosis. For young women the increase of the risk of breast cancer is not significant. Hormones are very effective medications.
Yes, there are a number of alternatives.
Lifestyle
Osteoporosis can be prevented through a calcium-rich diet- the earlier you start the better! Healthy food, rich on vitamins, no fasting and enough calcium is essential.
Adding calcium to your to your diet
1-2 times daily 500mg is the optimal doses in addition to your usual diet (-> perimenopausal women)
Substitution of vitamin D
800-1000IE daily, especially during winter and for postmenopausal women)
Activity, sports and strength training
A minimum of twice a week you should do sports, especially training for the back muscles is important. Construction of the bones only works when you put weight on them.
Ideal weight
No underweight!
Sunshine!
Spend some time outside: You should spend at least 30 minutes outside per day. Sunlight should shine on your face and forearms so that vitamin D can be produced in the skin.
If the osteoporosisprophylaxe is not successful and even a bone fractur occurs, there are different medications to treat osteoporosis:
Administrating bisphosphonate is often the first step so that further bone deterioration can be prevented; in addition, calcium and vitamin D are prescribed.
Also we have therapy with antibodies or parathormon to treat the osteoporosis.