Osteoporosis is a disease process making bones more fragile, therefore more likely to break, but is painless unless a fracture occurs. A fracture related to osteoporosis will impact 50% of women during their lifetime. This risk is much more pronounced in women than men because women achieve a lower peak bone mass, have smaller bone size, experience rapid bone loss related to menopause, and tend to live longer. The most common fracture site is the spine, second is the hip. These fractures lead to significant symptoms, morbidity, medical expense, and increased mortality.

Osteopenia is a precursor of osteoporosis. Risk factors associated with these bone changes include a history of a nontraumatic fracture as an adult, a first degree relative with such a history, low body weight (less than 127 pounds), long-term steroid use, or long-term smoking. Proper evaluation to determine the presence or absence of osteopenia or osteoporosis is bone densitometry. Initial evaluation is recommended at age 65, younger if risk factors are present, or a patient experiences early menopause. Results are compared to bone density of a normal 30-year-old women, generating "T scores". Normal is higher than -1.0, osteopenia is -1.5 or less. Osteoporosis is -2.5 or less . Treatment to reduce the risk of fracture is obviously indicated in osteoporosis, but also with osteopenia in the presence of risk factors noted, to prevent the natural progression of further bone loss and therefore increased risk of fracture.

Many more treatment options exist today than even ten years ago. Bisphosphonates may be taken weekly or monthly, Evista may be taken daily, and now we offer IV bisphosphonate therapy that avoids potential GI side effects. All of these treatments are quite effective, and when taken properly, significantly decrease one's risk of fracture. The risks associated with these medications are relatively uncommon, as are side effects. All must be used as directed, with appropriate calcium and vitamin D supplements.

More information is available at Washington Women's Care where we perform on-site bone densitometry by certified bone densitometry technicians, with interpretation by a certified bone densitometrist. Treatment recommendations and appropriate follow-up intervals are always included in these evaluations. More information is available on the website link to the National Osteoporosis Foundation as well.

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