Osteoporosis: a health issue for women

Osteoporosis is a debilitating disease, most of whose victims are women. This disease results when bone resorption lags behind bone formation, resulting in a net loss of bone. Although the underlying mechanisms have yet to be identified, we know that both aging and decreased estrogen levels promote osteoporosis. The weakened bone is susceptible to fracture and contributes to the morbidity and mortality rates of women over the age of 40. Nonmodifiable risk factors for the development of osteoporosis include being female; having a small, thin body build; and having lighter skin pigmentation. Modifiable risk factors include estrogen and calcium deficiencies, a sedentary lifestyle, smoking, excessive alcohol intake, and certain medical conditions. Restoring estrogen to premenopausal levels results in a slowing of bone loss and maintenance of bone levels for most women for whom estrogen replacement therapy is desirable. Of the treatments available, this one shows the most powerful and protective effect on bone. Because treatment cannot reverse the condition, considerable energy must be directed toward prevention of osteoporosis. Recommendations for prevention have been made on the basis of modifiable risk factors.