Click here for further information if your physician has ordered a bone density scan (Dexa Scan) for you.

Osteoporosis is a disease of bone weakness causing fragility fractures. Although this disease can happen for many reasons, at any age in men or women, a large preponderance of this disease burden falls upon the shoulders (and spines and hips!) of postmenopausal women. Hormonal changes at menopause cause a change in bone metabolism, starting a steady decrease in bone mineral content and structure. This bone loss can be exacerbated by lifetime nutritional and exercise habits (or lack thereof), current medical conditions and required medicines, vitamin deficiencies, and risks of falling with advancing age.

The Womens Clinic Ltd., features the Dexascanner scanning device. This is a quick, painless procedure for measuring bone loss. It is most often used to diagnose osteoporosis, with bone denity measurements of the lower back and hips mainly taken.

Far from being inevitable, as once was thought, osteoporosis can be prevented and treated to optimize quality of life and prevent suffering and risk of death.

The Scope of the Problem

The National Osteoporosis Foundation in Washington, DC estimates that more than 25 million Americans, most of whom are women, have osteoporosis. Even more have osteopenia, a problematic but lesser degree of bone loss. In the U.S. alone, each year, more than one million fractures occur, with health costs just to treat these fractures of $13 billion dollars per year. Hip fractures each year cause 50,000 deaths in the U.S.A. alone, with more risk expected as our baby boomers reach menopause and beyond.

However, the advances in the past two decades in diagnosis, treatment and prevention of osteoporosis have been dramatic. Standardized testing of bone density, with a DXA test, has allowed appropriate identification of individuals at risk. Awareness of common Vitamin D deficiency states has focused attention on basic needs for this vitamin as well as calcium associated health benefits of Vitamin D, especially in the role of the immune system are being explored. New data support previous recommendations of lifelong physical activity and health nutritional intake.

Medical intervention two decades ago was very limited with only estrogen replacement therapy for women. Now a host of well-documented safe interventions are available and approved by the FDA. Raloxifene is a selective estrogen receptor modulator (SERM), and more similar medications are in testing. Bisphosphates are medications that directly treat bone metabolism and mineralization and are not hormonal. There are oral forms – Alendronate (oral dose weekly), Risedronate (oral dose weekly), Ibandronate (oral dose monthly or intravenous dose every 3 months) and Zolandronate (intravenous dose yearly). The safety profile and efficacy of these medications is well documented. Calcitonin is a bone hormone treatment for osteoporosis fractures in particular, available as a nasal spray and a daily shot. Lastly – human parathyroid hormone (hPTH) is a daily shot that acts in a unique fashion to build up good quality bone. There are also newer restorative surgeries for painful and debilitating fractures, as well as basic safety issues, physical therapy, and mechanical interventions to minimize the risk of falls.

Awareness of this condition and its risks has increased worldwide as well as nationally. New data in early 2008 from the WHO (World Health Organization) is being used to calculate an individual's risk of fracture, specifically hip fracture, in the next 10 years. This statistical tool will be useful to guide therapy and help patients and physicians make appropriate treatment decisions to minimize risk and maximize health and good bone function in the years and decades to come.

FRAX - Fracture Risk Assessment Tool developed by the World Health Organization. Click to fill out the online questionnaire.