One of the most important problems osteoporosis Although it actually starts from the age of 20, the loss until menopause is insignificant. In women, the main loss occurs after menopause. The main reason for this is the female hormone estrogenis the lack of it.
After menopause, bone loss occurs at a rate of 1-1.5% per year. 20 years after menopause, 30-40% loss occurs. As a result shortening in height and there is a tendency for fractures. Studies have shown that 25% of 70-year-old women have osteoarthritis in their back or waist bones and 20% of 90-year-old women. hip fracture It was found that .
Osteoporosis increases with age and is more common in women than in men. In women with a thin general body structure, in women with a family history of osteoporosis or bone fracture, or in women with a history of shortening in height, in women who spontaneously went through menopause before the age of 45 or due to surgical removal of the ovaries. surgical menopause Osteoporosis is seen earlier and more severely in women.
Which bones does osteoporosis most commonly affect?
Osteoporosis is the most common burden-bearing disease of the body. vertebrae effects. 45-50% of all osteoporosis occurs in the vertebrae, 20% on the hip (at the head of the femur), 10-15% on wrists and 20% occur in other bones.
As a result, especially in older ages, there may be a shortening in height due to collapse fractures in the vertebrae (a woman's height may decrease up to 15-20 cm in older ages!), as well as life-threatening fractures in other bones, especially in the hip, as a result of minor falls or spontaneously.
Apart from this, in women who cannot menstruate for a long time, with food calcium intake in women with low calcium levels (the most important sources of calcium are milk and dairy products), in those with a sedentary lifestyle, in women who smoke and drink excessive alcohol, in those who lack sunlight and therefore vitamin D, in those who have to use cortisone and some other medications, and in those with various hormonal diseases, especially hyperthyroidism (high thyroid hormones). osteoporosis (bone loss) The risk is high.
It is observed radiologically in 21% of women over the age of 70, even though they have no symptoms. The risk of hip fractures begins to increase 10-15 years after menopause, and the risk of hip fracture for women over the age of 85 is 20%.
Moreover, approximately 15% of these hip fractures are severe enough to result in death within the first three months.
Additionally, unfortunately, approximately 30% of older women who experience hip fractures permanent disability can develop!
How is osteoporosis diagnosed?
classic x-ray Osteoporosis can also be suspected with radiographs, but in order to be diagnosed with this method, bone loss must be at least 40%. advancedThere must be osteoporosis. This is actually quite common when diagnosed. it's late It means.
Today, it is the most sensitive and appropriate method used in the early diagnosis and treatment follow-up of osteoporosis. DEXA It is a technique called . With the DEXA method, the femur area, vertebrae and arm bones, which are the most sensitive bones of the body, are examined and a precise diagnosis can be made.
Expressions such as "normal", "osteopenia" (mild osteoporosis), "osteoporosis" and "advanced osteoporosis" may be used in the DEXA report.
In addition, bone measurements should be taken at regular intervals in women receiving osteoporosis treatment to monitor the treatment.
Even in women who have no complaints, bone measurement is recommended once when they enter menopause and then at five-year intervals.
Treatment of osteoporosis
The main goal of treatment is to prevent fractures from occurring. It is not actually possible to completely restore the bone lost during the osteoporosis process. However, osteoporosis can be stopped to a large extent with some treatments. As a result, the risk of fracture is significantly reduced, except in cases of advanced osteoporosis.
It is now definitely proven that estrogen therapy slows down the process. A 50-60% reduction in arm and hip fractures can be expected in those receiving estrogen therapy, and an 80% reduction in spinal bone fractures can be expected when calcium intake is also provided (consuming calcium-rich foods and calcium treatment in the form of medication when necessary).
For estrogen therapy to be effective, treatment must continue. When treatment is stopped, the osteoporosis process continues as it was before treatment.
Calcium absorption decreases with age, and the decrease becomes more pronounced especially after menopause. Maintaining calcium balance is one of the most important steps in preventing osteoporosis. However, in cases where estrogen is low, calcium may not be effective no matter how much calcium is taken. Therefore, in addition to estrogen therapy, it is important to take 1000 grams of calcium daily into the body through food or medication.
In cases where estrogen therapy is undesirable calcitonin, raloxifene, alendronate, risedronate Medicines that directly target osteoporosis, such as osteoporosis, can also be used. Your doctor will guide you in choosing your medication.
Apart from drug treatment, some lifestyle changes must be made to prevent osteoporosis or stop its progression.
Meanwhile, there is evidence that smoking accelerates bone loss and even accelerates menopause.
Doing sports that do not strain the body for at least 30 minutes a day, 3 times a week, significantly improves the mineral amount of the bone during menopause. 2-2.5 km a day for women in menopause. Walking is recommended.
Smoking and alcohol should be quit. Necessary changes should be made to get enough calcium through a balanced diet.
Since bone loss is faster in the early periods after menopause, it is necessary to start treatment as early as possible.
With hormonal treatment, bone fractures can be reduced by approximately 50%. When calcium was added to the treatment, an 80% reduction in back and spinal fractures was detected. In addition, vitamin D should be added to the treatment for women over the age of 70 and those living in areas where there is little sun.