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OsteoporosisThis factsheet is for people diagnosed with osteoporosis or for those who want to know more about it. Osteoporosis means porous bones. Bones affected by osteoporosis are less dense than normal bones. They are also more likely to break, as a result of a minor bump or fall, or even without an injury. Osteoporosis occurs in about 5 in every 100 people in the UK. It is around four times more common in women than men, and most common in women who have been through the menopause. About one in two women and one in five men over the age of 50 will break a bone because of the condition. Osteoporosis animationWhat is osteoporosis?Osteoporosis is a condition that causes your bones to weaken, making broken bones more likely. What are the symptoms?Osteoporosis is sometimes called the "silent disease". Most people affected are unaware that their bones are thinning until they break one. Hip and wrist fractures are the most common breakages, but they can occur in any bone. Osteoporosis can result in small fractures in the bones of your spine, causing a loss of height and a curved back (sometimes known as "dowager's hump"). This can lead to long-lasting neck and back pain. What causes osteoporosis?Healthy bone consists of a strong mesh made of protein and minerals (particularly calcium). This mesh is living tissue that is constantly being renewed in a process called bone turnover. Old, worn out bone is broken down and absorbed by the body while, at the same time, new bone tissue is created from fresh protein and minerals.
In children and young people, more new bone is created than is broken down. This makes bones bigger and more dense. Bones are at their strongest when peak bone mass is reached, which usually happens in your mid-twenties. This is maintained for about ten years, with roughly equal amounts of bone creation and breakdown. After the age of about 35, bone loss begins to overtake creation as part of the normal ageing process. If you have osteoporosis, this process happens much more quickly, making your bones become weaker and more prone to fracture. Who gets osteoporosis?Some people are more likely to develop the disease than others. The strongest risk factors are listed below.
Low levels of oestrogenThe hormone oestrogen reduces the amount of bone that is broken down and so helps to protect against osteoporosis. In women, the ovaries make oestrogen from puberty to the menopause. Any condition that reduces the number of years that a woman produces oestrogen tends to increase the risk of osteoporosis. This includes:
Other risk factorsMen who have lower than normal levels of the hormone testosterone (hypogonadism) have a greater risk of osteoporosis. For both men and women, the following factors also increase the risk of developing the disease:
Can I prevent osteoporosis?You may be able to reduce the chances of getting the disease by making changes to the way you live your life. A healthy diet and exercise can increase bone mass and reduce the risk of developing osteoporosis, especially in young people with growing bones. ExerciseLow-impact exercises where you support your own weight are best for strengthening bones. The National Osteoporosis Society recommends running, aerobics, tennis, weight-training and brisk walking. Ideally, try to do this type of activity for at least 30 minutes a day - this will also help to keep your heart healthy. (Please see the separate BUPA factsheet Looking after your heart). If you are not used to exercising, build up your exercise routine gradually, increasing frequency before intensity. Talk to your GP before you start if you have a health problem that affects your heart or breathing. DietEating a diet rich in calcium is important for maintaining healthy bones. Good sources of calcium include milk and dairy products, such as hard cheese and yogurt, and some green leafy vegetables and fruit. Your body also needs vitamin D to absorb calcium properly. Vitamin D is found in certain foods, including cod liver oil, sardines and tuna, as well as milk and eggs. It is also generated by your skin when you are in the sunlight, although care must be taken because exposure to the sun is known to cause skin cancer. Only brief, casual, sunlight exposure is needed. To reduce the risk of getting skin cancer, Cancer Research UK recommends that you cover your skin between 11am and 3pm, when the sun is strongest, and that you do not allow your skin to burn. LifestyleSmoking can have a harmful effect on your bone strength and can also cause an early menopause. If you smoke, try to give up. You should also be careful not to drink too much alcohol. Treatment for osteoporosisThere are now a number of effective treatments that can help prevent fractures and increase bone density. Some examples are listed below.
Hormone replacement therapy (HRT)HRT is a prescription-only treatment that aims to restore hormones to a pre-menopausal level. It is taken to relieve menopausal symptoms such as hot flushes, night sweats, and vaginal dryness. HRT has also been shown to reduce osteoporosis, but it is no longer prescribed to treat or prevent it. This is because taking it over a number of years increases the risk of stroke, blood clots in the veins, cancer in the lining of the womb, and breast cancer. It is now only prescribed for the shortest time needed to treat menopausal symptoms. Deciding whether to take HRT is your choice and your doctor will discuss the risks and benefits with you. Further information
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