New Weapons to Fight Osteoporosis
Battling Brittle Bones
Do Benefits Exceed Risk? continued...
According to Ettinger, a woman's decision to take hormone
replacement should not be based only on preventing osteoporosis, since there
are other options.
But more studies need to be done: The JAMA authors say
no large trial has tested what effect estrogen may have on fracture risk in
women who do have osteoporosis.
"The debate surrounding the use of HRT underscores the need
for a greatly expanded osteoporosis research effort, including definitive
studies of HRT," says National Osteoporosis Foundation director Sandra
Raymond in a June 2001 news release. "Osteoporosis is an enormous public
health problem, causing 1.5 million fractures annually. Until and unless the
osteoporosis research effort is greatly increased, these answers will not be
Women Have a Choice
Bones normally lose density as we age. Only a severe loss
results in osteoporosis. Experts say many things besides estrogen decline may
contribute to postmenopausal women developing the disease, including
- Family history
- Individual metabolism
- Parathyroid hormone
- Vitamin D
- Blood factors that direct cell growth
- Certain drugs
- Certain illnesses, including diabetes
According to Ettinger, "It's rare for women to be affected
much before age 65 or 70 and most of the fractures we worry about occur after
age 70 or 75. The average age for hip fracture is 81 and for spine fracture 72
or so. That's 25 to 30 years or so after menopause."
"Women can delay the decision to take a drug to prevent
osteoporosis and instead pursue reasonable lifestyle changes," he says.
"Why take a drug for years and years? Drugs cost money and have potential
side effects, as opposed to doing the right thing in your life. Instead,
reserve drugs for women who are at much higher risk."
Ettinger says: "I would suggest a woman ask, 'Is this going
to affect me in the next five to 10 years?' If so, take some of the good
medications available. We're getting better in treating the disease and the new
drugs are more powerful in restoring bone strength."
Make Lifestyle Changes
Besides drugs and hormones, there are simple steps women can
take to reduce their risk of getting osteoporosis, yet health advocates say
such measures are often ignored.
The National Women's Health Network counsels, "We advise
taking simple steps to prevent bone loss and fracture: exercise, appropriate
calcium intake, home safety precautions, and avoidance of drugs and other
chemicals (too much alcohol, caffeine, smoking, or excess salt) that can cause
additional bone loss."
Raymond, too, points to basics: "The truth is ... that
people are not taking care of their bones. In fact, our nation suffers from a
major calcium deficit. Women, girls, men, boys -- hardly anyone seems to be
getting the calcium they need each day."
Women can reduce their osteoporosis risk by
- Eating foods with calcium and vitamin D
- Exercising regularly
- Not using alcohol and caffeine excessively
- Not smoking
Years of such habits build strong bones that can carry most of
us safely through old age.