Osteoporosis: Who gets it, why does it occur, and how do you prevent it?

When your bones lose density and break easily, you have osteoporosis, which literally means ‘bones with holes’. This medical condition occurs when bones lose calcium and other minerals more quickly than the body can replenish them.

Most people don’t realise they have osteoporosis until they develop a fracture, typically in the hip, spine or wrist. It is for this lack of symptoms that osteoporosis is called a “silent” disease.

Who gets it most?

Women are four times more likely to suffer from osteoporosis than men, with post-menopausal women worst affected. Osteoporosis is common in Singapore, and the incidence of osteoporosis-related hip fractures in women over the age of 50 is eight times greater than the incidence of breast cancer.

“Half of women over the age of 50 will experience a fracture to their hip, wrist, spine, or other bone due to osteoporosis,” says Dr Linsey Utami Gani, a Consultant Endocrinologist at Changi General Hospital.

Women are at greater risk of developing osteoporosis because they tend to have smaller, thinner bones. Another reason is that oestrogen, the female hormone that protects bones, decreases sharply at menopause. A woman can lose up to 20 per cent of bone density in the first five to seven years after menopause.

Common risk factors for osteoporosis include:

  • Family history of osteoporosis
  • Inadequate intake of dietary calcium
  • Vitamin D deficiency
  • Smoking
  • Excessive alcohol consumption (more than two standard drinks per day)
  • Early menopause (before the age of 45)
  • Long-term use of certain medications, e.g. corticosteroids, anti-epileptics

Certain medical conditions can also increase your risk for osteoporosis. These include thyroid disease or an overactive thyroid gland, rheumatoid arthritis, chronic liver, kidney and lung diseases, and inflammatory bowel conditions.

How to treat osteoporosis:

Osteoporosis, which is diagnosed through a bone density test, cannot be cured. Treatment involves a combination of medication, supplements, a nutritious diet and regular physical exercise.

There is no standard treatment for osteoporosis and your treatment will be tailored to your specific needs, explains Dr Gani. “Generally, your overall risk of fracture will help your doctor decide on the best course of treatment for you. Some medications can reduce the risk of future fractures in osteoporosis,” she says.

How to prevent osteoporosis:

  • Consume adequate amounts of calcium through food or supplements
  • Maintain a normal vitamin D level
  • Do weight-bearing exercises regularly, e.g. walking, hiking, climbing stairs, and tai chi
  • Avoid smoking
  • Limit alcohol consumption