What is osteoporosis?
Osteoporosis (aus-tee-oh-por-oh-sis) is a disease of the skeleton that usually affects older men and women. When you have osteoporosis, your bones become fragile and there’s a greater risk of bone fractures.
The most common sites of fractures are the hip, spine, wrist and ribs.
What are the symptoms of osteoporosis?
Osteoporosis can have a major effect on quality of life. It can cause pain, disability and depression, leading to feelings of a loss of independence and social isolation.
Bone fractures can cause a loss of height or curving of the spine, which can make it hard to breathe normally.
What causes osteoporosis?
Bones are at their strongest in your early 20s, and gradually weaken as you get older.
Osteoporosis happens when old bone is replaced with new bone too quickly. This causes the bone to lose minerals, such as calcium, more quickly than the body can replace them. Without these minerals, your bones lose thickness (density) and strength. Thinner, less solid bones mean that even a minor accident can cause serious fractures.
One cause of osteoporosis is low testosterone. Testosterone is a male sex hormone that’s important for a range of body functions. If you have low testosterone levels, this can cause your bone to replace itself too quickly and become fragile, which means you’re more likely to have bone fractures.
Low testosterone levels aren’t the only cause of osteoporosis in men. A range of factors, including genetics, can have an influence on bone density.
Some osteoporosis is caused by too much exercise and poor nutrition. Too much exercise can put bones under a high level of stress, causing them to fracture easily. However, regular physical activity can lower your risk of fractures by improving muscle mass, balance and bone strength.
Very high levels of the stress hormone cortisol can also lead to rapid bone loss, and is a major cause of osteoporosis in men. The most common cause of high cortisol levels is corticosteroid medicines such as prednisolone, which is often used for asthma, arthritis and kidney disease.
High levels of thyroid hormone and parathyroid hormone can also cause osteoporosis in men.
What can I do?
A history of fractures, especially within the past five years, suggests that you might have osteoporosis. If this is the case, it’s a good idea to have your doctor assess your fracture risk and diagnose osteoporosis. They’ll do this by taking a medical history, measuring height, and doing other tests.
Lifestyle factors, including low levels of physical activity, smoking, excessive alcohol intake, and low calcium or vitamin D levels can increase the risk factor of osteoporosis. Things you can do to help prevent osteoporosis include having a healthy lifestyle, making sure there’s enough calcium in your diet, keeping your vitamin D levels normal, and exercise such as walking, jogging and lifting weights.
If osteoporosis is diagnosed early and treated, bone loss can be slowed down. Having a healthy lifestyle by not smoking, limiting alcohol intake and being active could lower your risk of osteoporosis.
Getting enough calcium and vitamin D each day is also important to keep bones healthy. You can get enough calcium by eating three to four serves of dairy foods such as milk, yoghurt and cheese daily. You can also take calcium tablets if you don’t have enough calcium in your diet. Vitamin D tablets and/or exposure to sunlight can increase your vitamin D levels.
What treatments are there for osteoporosis?
Your doctor can talk to you about medicines that might stop further bone loss, improve bone mass, and prevent spinal fractures. All the medications available for osteoporosis are effective, with a very small likelihood of side-effects.
If you have low testosterone levels, then returning these testosterone levels to normal can improve bone density. There’s no evidence that testosterone therapy improves bone density if you have normal levels of testosterone.
Your doctor’s appointment
Questions to ask your doctor
What treatment options are available for osteoporosis?
Do I need to take calcium and vitamin D supplements?
What type of exercises are okay for my condition, and what should I avoid doing?
Things to think about before your appointment
Do you have a family history of osteoporosis?
Have you had any bone fractures in the past five years? Have you ever had any therapy for thinning bones?
Have you ever taken any corticosteroid medications (i.e. prednisolone or dexamethasone) for long periods?
Do you have a history of low testosterone (androgen deficiency)?