Orion - Osteoporosis

Who gets it?

Many patients with osteoporosis are post-menopausal women. Women are more prone to osteoporosis as they can lose up to 20% of their bone mass in the 5 to 7 years after menopause. The hormone oestrogen protects bones and maintains its healthy turnover. With menopause, there is a significant fall in oestrogen production, leading to more bone resorption (taken away) and lesser bone replaced.

Men are also affected by osteoporosis, but this is far less common. Men’s bone health is controlled by both the oestrogen and testosterone hormones. Osteoporosis in men is mostly affected by lifestyle factors and medication.

There are, however, other factors such as medication, lifestyle and certain diseases that could lead to osteoporosis.

Lifestyle factors
• Sedentary lifestyle
• Smokers
• Alcoholics
• Low body weight
• Positive family history

Medication causing osteoporosis
• Long term steroids
• Chemotherapy medication

Medical conditions
• Chronic renal failure
• Liver disease
• Cancer
• Rheumatoid arthritis
• Hyperthyroidism
• Type 1 Diabetes Mellitus (DM)

Is osteoporosis dangerous?

Osteoporosis is also known as the ‘Silent Disease’. In the early stages of the disease, there may not be any clear symptoms. As osteoporosis progresses, symptoms begin to show and these include back pain, fractures, poor balance, loss of height and a reduced life span. Patients are also known to have shortness of breath and trouble with their lungs (smaller lung capacity due to compressed spine).

Over the last 30 years in Singapore, the cases of hip fractures have increased 5 times in women aged 50 and above, and only less than double in men of the same age group.

Who needs a DEXA scan?

All women 65 years and older, and all men 70 years and older
Women under 65 years old with risk factors (estrogen deficiency, low body mass, amenorrhoea before 42 years old)
Men and women of any age with the following risk factors:

Family history of osteoporosis
Vit D deficiency
Loss of height
Alcohol or cigarette use
Prolonged immobilisation
Long term steroid use
Fragility fracture (bony fracture around the hip, shoulder, spine, pelvis or wrist)
Hyperthyroidism or hyperparathyroidism

Medication for osteoporosis

The diagnosis for osteoporosis is based on your BMD results, blood results or a recent history of fractures, and will be determined by your orthopaedic surgeon or physician. Where managing lifestyle factors and calcium supplementation may be insufficient, further medication may be required to overcome osteoporosis.

There are several types of medication to treat osteoporosis, ranging from weekly oral medication to daily or 6-monthly subcutaneous injections. Each type has its advantages and disadvantages but are designed to build stronger bones and prevent fractures and other complications.

Some medications include:

Bisphosphonates
Hormone replacement therapy (HRT)
Selective oestrogen receptor modulators (SERMs)
Calcitonin
RANK ligand (RANKL) inhibitor

Summary

Osteoporosis is a silent disease of the bones causing fractures and pain. It affects mostly post-menopausal women and to a lesser extent, men beyond 50 years old. There are multiple things we can do in our daily lives to build up our bone health and prevent osteoporosis. This includes a well-balanced diet, weight bearing exercises and enough sunlight exposure. For patients with osteoporosis, adequate calcium and vitamin D supplementation goes a long way to maintain bone strength. In some patients, specific osteoporosis medication may be required to regain your bone health and integrity.

At Orion Orthopaedic, we believe in providing a tailored approach for individual patients to help them achieve better standards of living. Schedule a consultation with our orthopaedic surgeon Dr Mizan Marican today for a bone density screening and understand more about how we can help you achieve a better quality of life.

Conditions

Osteoporosis

What is Osteoporosis?

Who gets it?

Is osteoporosis dangerous?

Diagnosis and management

Who needs a DEXA scan?

Blood tests for osteoporosis

Medication for osteoporosis

Summary

Osteoporosis (Bone Mineral Density) Screening

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