May is Osteoporosis Awareness Month, and there’s no better time to learn about this “silent disease” that affects millions of women after menopause.
The Invisible Threat to Your Bones
Picture this: You’re going about your daily routine—reaching for a book on a high shelf, bending to pick up something you dropped, or simply stepping off a curb. Suddenly, you hear a crack and feel intense pain. What just happened? You may have experienced a fragility fracture—the hallmark sign of osteoporosis.
Osteoporosis is often called the “silent disease” because it has no symptoms until a bone breaks. By then, significant damage has already occurred. This May, as we observe Osteoporosis Awareness Month, let’s pull back the curtain on this common but often misunderstood condition.
What Exactly Is Osteoporosis?
Think of your bones as living structures constantly under construction. Throughout your life, your body breaks down old bone tissue and builds new bone. When you’re young, bone formation outpaces breakdown, resulting in stronger, denser bones. But as we age, and especially after menopause, this balance shifts.
Osteoporosis occurs when bone breakdown exceeds bone formation, leading to:
- Lower bone mass
- Disruption of bone architecture
- Increased skeletal fragility
- Higher risk of fractures
The result? Bones that were once strong become porous, fragile, and prone to breaking—even from minor bumps or falls.
Why Should You Care Now?
You might be thinking, “I feel fine. My bones don’t hurt. Why worry about osteoporosis?”
Here’s why: By the time a fracture occurs, osteoporosis is already advanced. The most common sites for osteoporotic fractures are the spine, hip, and wrist. These aren’t just painful, they can dramatically impact your quality of life:
- Spinal fractures can cause height loss, stooped posture (sometimes called “dowager’s hump”), and chronic back pain
- Hip fractures often require surgery and may lead to loss of independence
- Wrist fractures can limit your ability to perform everyday tasks
Even more concerning: approximately two-thirds of spinal fractures cause no immediate symptoms and are discovered only incidentally on X-rays taken for other reasons. You could have osteoporosis right now and not know it.
Are You at Risk?
The two biggest risk factors for osteoporosis are being female and going through menopause. Why? Because estrogen, which helps protect bone density, drops dramatically during menopause.
Other risk factors include:
- Advancing age
- Family history of osteoporosis
- Small, thin body frame
- White or Asian ethnicity
- History of fractures
- Smoking or excessive alcohol consumption
- Sedentary lifestyle
- Certain medications (like steroids)
- Low calcium intake throughout life
- Vitamin D deficiency
How Do You Know If You Have It?
The gold standard for diagnosing osteoporosis is a bone mineral density (BMD) test using dual-energy X-ray absorptiometry (DXA). This painless, non-invasive test measures bone density at your hip and spine.
Your results will be given as a T-score:
- Normal: T-score of -1.0 or above
- Low bone mass (osteopenia): T-score between -1.0 and -2.5
- Osteoporosis: T-score of -2.5 or lower
But here’s an important fact: You can be diagnosed with osteoporosis even without a BMD test if you’ve had a fragility fracture, a break that occurs from standing height or less.
Taking Action: What You Can Do
The good news is that osteoporosis is both preventable and treatable. Here’s how to start:
1. Get Tested
If you’re a woman over 65, or younger with risk factors, talk to your healthcare provider about a bone density test.
2. Boost Your Bone-Building Nutrients
- Calcium: Aim for 1,200 mg daily from food sources like dairy products, leafy greens, and fortified foods
- Vitamin D: Necessary for calcium absorption; get 800-1,000 IU daily through sunlight exposure, fatty fish, egg yolks, and supplements if needed
3. Move More
Weight-bearing and resistance exercises help build and maintain bone density. Try:
- Walking
- Jogging
- Dancing
- Weight training
- Yoga or Pilates (with proper modifications)
4. Make Lifestyle Changes
- Quit smoking
- Limit alcohol to one drink per day
- Reduce fall risks in your home by removing tripping hazards
- Use proper lighting, especially at night
5. Consider Medication If Needed
Several effective medications can slow bone loss or even increase bone density. These include:
- Bisphosphonates
- Hormone therapy
- Selective estrogen receptor modulators
- Biologic therapies
The Bottom Line
Osteoporosis doesn’t have to be your destiny. Understanding your risk, getting appropriate testing, and taking preventive actions can help you maintain strong bones throughout your life.