Patient Education

Women: 45+
Learn to protect your bones and keep your independence.

Inside Pamphlet
Osteoporosis What is osteoporosis? How common is osteoporosis? Who is at risk? How is osteoporosis diagnosed? How to prevent osteoporosis? Do I need treatment for osteoporosis? Other important measures

Osteoporosis and Treatment

What is Osteoporosis?
Osteoporosis is a condition that affects bone strength. Bone is made of collagen fibers and minerals. It is a living tissue and contains cells that make, mold, and resorb bone. Initially, as you grow, bone formation exceeds bone resorption. But, as you get older, this reverses and, after about the age of 45, you start to lose a certain amount of bone material. Your bones become less dense and less strong. The amount of bone loss can vary. If you have a lot of bone loss then you have osteoporosis. If you have osteoporosis, your bones can break more easily than normal, especially if you have an injury such as a fall. If you have a milder
Normal Bone Bone with Osteoporosis

Bisphosphonates What are bisphosphonates? When are bisphosphonates usually prescribed? How well/quickly do bisphosphonates work? What is the usual length of treatment? What are the possible side effects?

degree of bone loss, this is known as osteopenia.

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How common is osteoporosis?

Women lose bone material more rapidly than men, especially after menopause when their estrogen levels fall. Estrogen is a hormone and helps to protect against bone loss. At the age of 50, about 2 in 100 women have osteoporosis. This rises to 1 in 4 women at the age of 80.

Who is at risk of osteoporosis?

While all men and women have some risk of developing osteoporosis as they become older, women are more at risk than men. The following may also lead to excessive bone loss and will increase your risk of developing osteoporosis. If you: Are a woman and had your menopause before the age of 45 Have already had a bone fracture after a minor fall Have a strong family history of osteoporosis Have a body mass index (BMI) 19 or less Are a woman whose periods have stopped for six months to a year before menopause Are a smoker or heavy drinker Lack calcium or vitamin D Have never taken regular exercise or have led a sedentary lifestyle Have, or had, certain medical conditions that causes poor mobility

How is osteoporosis diagnosed?

Osteoporosis usually develops slowly over several years, without any symptoms. However, after a certain amount of bone loss, the following may occur: A bone fracture after a minor injury such as a fall Loss of height, persistent back pain and a stooping (bent forward) posture

Usually, osteoporosis is first diagnosed when you break a bone after a minor bump or fall. Even after a fracture has occurred, you can still take steps to reduce your risk of further fractures. If you are thought to have sustained a fracture due to osteoporosis, you will usually be referred for a DEXA scan to look for signs of osteoporosis. 2

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How can I prevent osteoporosis? Do I need treatment for

The following actions can help prevent, or slow down, bone loss, even if you currently have osteoporosis. Exercise The pulling and tugging on the bones by your muscles during exercise help to stimulate bonemaking cells and strengthens your bones. This involves exercise where your feet and legs bear your bodys weight, such as brisk walking, aerobics, dancing, running, etc. You should aim for at least 30 minutes of moderate exercise or physical activity at least 5 times per week. Additionally, muscle strengthening exercises such as lifting weights is important to increase tone and improve balance. Food and Diet For the adult over age 50, it is recommended to have a daily calcium intake of at least 1,000mg per day and a daily vitamin D intake of 800IU per day. Smoking and Drinking

osteoporosis?

If you have osteoporosis without a fragility fracture, you doctor will be able to determine whether or not treatment is recommended in your case. They may use a special risk calculator - which takes in account all your risk factors, bone density, age, and health status - to determine your risk of a fragility fracture. If you have been diagnosed with osteoporosis and have already had a fragility fracture, treatment is usually recommended to help prevent further fracture. The bisphosphonate drug alendronate is usually suggested first. If bisphosphonates are not suitable or tolerated, other treatments may be suggested depending on your age, bone density measurements and how many other risk

Additional Information

While treatments are available for osteoporosis, medications will not restore all lost bone and may not be recommended for all Chemicals from tobacco can get into your bloodstream and can affect your bones, making people. Therefore, lifestyle factors are bone loss worse. If you smoke, you should try to important in treating osteoporosis. They include weight-bearing exercise, muscle make every effort to stop. Also, it is recommended to cut down any alcohol intake if strengthening exercise, not smoking and lower alcohol levels as described earlier. you drink more than 3 units of alcohol daily. Hormone Replacement Therapy (HRT) HRT contains estrogen and was widely used to prevent osteoporosis. However, recent findings on the long-term health risks of HRT have relegated the use of HRT to women who have had an early menopause. There is a small increased risk of breast cancer and cardiovascular disease with long-term HRT use. Therefore, it is not recommended for women with a family history of these conditions. You should also take precautions to prevents yourself from falling and breaking a bone. Check your home for hazards such as uneven, rugs, wires, or slippery floors. Are your vision and hearing as good as possible? Beware of going out in icy weather

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Osteoporosis & Bisphosphonates

What are bisphosphonates?
Bisphosphonates are commonly used in the treatment of osteoporosis. These medications may be administered in pill form or intravenously. They bind to bone and limit its reabsorption, thereby slowing down the rate at which you lose bone mass. They may even help to restore bone in some cases.

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What is the treatment like?

Only your doctor can prescribe the right kind of bisphosphonate and the correct treatment for you. However, many experts agree that bisphosphonates should be taken over the span of a few years (5 or more, as a rule of thumb, although some prescriptions may extend to the end of your life).

When are bisphosphonates prescribed?

Bisphosphonates are usually prescribed for people who: Have osteoporosis and have already had a bone fracture or break Have low bone density (osteopenia or osteoporosis) and may be at risk of fracture

What are the side effects?

Most of the side effects of bisphosphonate treatment are very mild. Side effects may include: Heartburn Difficulty or painful swallowing Chest pain Nausea Indigestion Mild inflammation Oesophageal ulcers Osteonecrosis of the jaw (very rare)

Are bisphosphonates effective?

Research indicates that bisphosphonates help to reduce the fracture risk for many patients with osteoporosis. Most patients taking bisphosphonates show a reduction in bone remodeling, and many women show reductions in remodeling that are comparable to healthy premenopausal women.

References:
Cox, J., Kenny, T., and Tidy, C. (2012, February 2). Osteoporosis. http://www.patient.co.uk/health/osteoporosis-leaflet Khosla, Sundeep, John P. Bilezikian, and David W. Dempster. "Benefits and Risks of Bisphosphonate Therapy for Osteoporosis." The Journal of Clinical Endocrinology & Metabolism 97.7 (2012): 2272282. Benefits and Risks of Bisphosphonate Therapy for Osteoporosis. Web Whitehall, Jenny. "Bisphosphonates." Patient.co.uk, 11 Aug. 2011. Web. 02 Oct. 2013. http://www.patient.co.uk/health/bisphosphonates.

Do bisphosphonates start working right away?

It usually takes several months of treatment for bisphosphonates to work. Generally, an increase in bone density does not occur for 612 months after the first dose.