Osteoporosis: Slow Developing Disease Affects 1 in 5 American Women

Pharmacists can advise patients on medications and lifestyle changes to help prevent or treat osteoporosis.

Welcome to the inaugural post for Pharmacy Times’ Osteoporosis Condition Center. Here, pharmacists can learn about developments in disease treatment and prevention and listen to podcasts or watch videos about the disease.

Osteoporosis is the most common bone disease, affecting 1 out of 5 American women. It typically occurs as the body reabsorbs calcium and phosphate from the bones as part of the aging process, leading to brittle and fragile bones. The loss typically occurs over a period of years, without pain or outward symptoms.

Most individuals with osteoporosis are unaware they have the disease until their bones have been significantly weakened. Symptoms include back pain from fractured or collapsed vertebra, gradual loss of height, stooped posture, and fractures that occur with little or no trauma. According to the National Institutes of Health, half of all women over the age of 50 will experience a fracture of the hip, wrist, or vertebra as a result of osteoporosis.

Causes of the disease include reduced levels of estrogen or testosterone, taking daily corticosteroid medications for longer than 3 months, hyperparathyroidism, vitamin D deficiency, eating disorders, and chronic diseases such as rheumatoid arthritis and kidney disease.

Risk factors include female gender, advanced age, being white or of Asian descent, family history, and small frame size. Other risk factors include consuming large amounts of alcohol, undergoing hormone treatment for prostate or breast cancer, low body weight, smoking, amenorrhea, and too little calcium in the diet.

Although fractures are a hallmark of the disease, normal X-rays can only detect bone loss after bone density has been reduced by 25% to 40%, according to the National Osteoporosis Foundation. Bone mineral density testing, which estimates the density of bone and risk of fracture, is the only test to diagnose the condition before a fracture occurs.

Osteoporosis can be treated with several classes of medication as well as lifestyle changes. Bisphosphonates, which prevent the resorption of bone, can be prescribed to prevent or treat osteoporosis. They can be taken orally once per week or month or via less frequent injections. Hormone replacement therapy with estrogen or testosterone can help maintain bone density. In women, estrogen therapy typically begins shortly after the onset of menopause. Patients should be aware, however, that the treatment can increase the risk of blood clots and endometrial and breast cancer.

Pharmacists can also recommend lifestyle adjustments, such as consumption of adequate amounts of calcium and vitamin D to maintain bone health before the onset of osteoporosis. In addition, exercise can help build bones and slow bone loss.

To start exploring the Pharmacy Times Osteoporosis Condition Center, check out our other inaugural posts:

• Task Force Recommends Against Vitamin D, Calcium Supplements
• FDA Report Advises Caution Over Long-Term Bisphosphonate Use
• Hormone Replacement Therapy: Do the Risks Outweigh the Benefits?
• Calcium Supplements Linked to Heart Attack
• Implanted Chip Successfully Delivers Osteoporosis Drug