Why as a woman do I have a higher risk for osteoporosis?
Ethel Siris, MD:
Women are at higher risk than men for a couple of reasons we think. One is that on average, women have smaller frames than men. Now a lot of this is just, you know, basic common sense.If you've got bigger bones, it's harder to break them than if you've got smaller bones, so that's one issue.The second issue is that women go through menopause. Menopause is when your ovaries stop making the larger amounts of estrogen that they were previously making.And when estrogen levels dip, unfortunately, certain chemical factors in the blood shoot up.And those factors bring bone eating cells to the bone. Cells called osteoclasts that normally remove small amounts of bone in order to allow skeletal remodeling,which means your skeleton has to be refreshed and replenished. You remove a little bit of older bone, you put down new bone.In the absence of estrogen, you wind up removing much too much bone and the bone forming cells that are trying to replace it can't keep up, so you lose bone.Now, if a woman is taking estrogen after menopause for quality of life reasons, this won't happen.Many women today don't want to take estrogen for very good reasons. And in those women, if the bone problem is sufficient, we have non-hormonal ways of correcting that bone problem,not with estrogen, but with some of these other medications.