Osteoporosis is a widespread disease that participates in formation of fractures with a variety of potentially serious complications.


Under normal circumstances, the bones of adults are in constant reconstruction according to the actual direction of their load. Bone is a dynamic structure that is both formed and degraded and these two activities are in balance. Bone formation is supported by regular physical exercise, adequate calcium and vitamin D intake and in women there is a significant positive effect of estrogen. In osteoporosis, the balance is moved toward the degradation resulting in thinning of the bone tissue. The bone becomes weak and brittle and it is prone to fractures.


Osteoporosis is usually a result of more causative factors. Its risk increases with age and it is also related to low intake of calcium and vitamin D. In women, the risk of osteoporosis increases after the menopause when they lose the protective effect of sex hormones. Hormonal factors include overactive thyroid gland, adrenal disorders and long-term intake of corticosteroids. Decrease of bone density is also reported in chronically immobilized patients.


The osteoporosis manifests with bone pain, especially vertebral pain, and by occurrence of pathologic fractures, i.e. bone fractures occurring due to inadequately low physical force. The most common are fractures of ribs, vertebrae, ulna and femoral neck. The consequences may be fatal, typically in case of broken femoral neck. When the fracture causes immobilization, the patient is very prone to infectious complications such as pneumonia. This is the reason, why even a simple fracture may be easily life-threatening for the elderly and people with weakened immunity.


The diagnosis of osteoporosis can be stated by densitometry. Densitometer is a special X-ray machine that uses only small dose of radiation. The computer evaluates the bone density according to resistance of the bones to the radiation energy and the amount of absorbed radiation by the bone tissue.


Prevention is of great importance, especially in older women who are in combined risk of age and menopause. The best prevention is adequate and regular intake of calcium in diary products (milk, cheese and yogurts) and sensible exposure to sunlight to assure production of vitamin D. Reasonable physical activity can be also advised as it helps to stimulate the bone formation.


The doctor has a large variety of drugs to prescribe. In postmenopausal women, hormonal therapy would be very helpful, but it is related to increased risk of some gynecological cancers (breast cancer and endometrial cancer). This led to development of modern medications that act similarly to estrogen but without its negative effects. In addition, the doctors usually prescribe supplements containing vitamin D and calcium.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources