What causes osteoporosis?

Osteoporosis can either be primary or secondary, depending on the cause.

Primary osteoporosis

Osteoporosis may develop as a result of natural bone loss – as you grow older, your bones become thinner and weaker. This is known as primary osteoporosis. Other factors that may determine if you will suffer from osteoporosis and fractures are:

  • Gender – Women lose significant amounts of bone during the first few years after menopause due to falling estrogen levels. This makes women especially vulnerable to osteoporosis.
  • Body size – Women with smaller body sizes have smaller and thinner bones, making it more likely that they will develop osteoporosis.
  • Family history – Your chances of developing osteoporosis are greater if your parents have had fractures related to osteoporosis. In particular, your chance is greater if your mother had a hip fracture.

Your lifestyle can also play a role in the health of your bones. You may be at risk of developing osteoporosis if you:

  • have not had an adequate intake of calcium and vitamin D throughout your life
  • lead an inactive lifestyle and don’t exercise
  • drink a lot of coffee, soft drinks, energy drinks or other beverages that contain caffeine (more than 4 cups a day)
  • drink alcohol in excess (more than 2 drinks a day on a regular basis)
  • smoke cigarettes

Secondary osteoporosis

Some medical conditions or diseases can affect the health of your bones. In addition, certain medications such as steroids can decrease bone formation or increase bone loss. Osteoporosis arising from such situations is referred to as secondary osteoporosis. Over 50% of men with osteoporosis have secondary osteoporosis and about 20-30% of women who have reached menopause are affected by secondary osteoporosis.

Your risk of osteoporosis increases if any of the following are applicable to you:

  • Medications – Long-term use of certain drugs can lead to loss of bone density. A class of drugs known as glucocorticoids (e.g. prednisone) is most commonly associated with secondary osteoporosis. Other high-risk medications include aromatase inhibitors (used for breast cancer) or androgen deprivation therapy (used for prostate cancer).
  • Hyperparathyroidism or hyperthyroidism and other illnesses that affect the endocrine system.
  • Crohn’s disease or celiac disease or other gastrointestinal (digestive) tract diseases.
  • Liver diseases.
  • Premature menopause (i.e. menopause before 45 years of age).
  • Hypogonadism – Hypogonadism is a medical term referring to little or no production of hormones by your sex glands. Low testosterone in men and absence of menstrual periods in younger women may lead to osteoporosis.

Can my bones become healthy again?

The main goal for osteoporosis patients is to avoid fractures. Even if you have been diagnosed with osteoporosis, it is not too late to take charge of your bones. Your doctor may prescribe medication to stop bone loss and increase bone formation and density. If you are not already on an exercise program, talk to your doctor about building bone mass through weight-bearing exercises and weight-training. Take safety precautions to prevent falls. All of these will help to reduce your fracture risk.

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