When most women approach menopause, they tend to focus their attention on three symptoms: hot-flashes, mood swings and weight gain. These symptoms can be problematic and certainly may affect quality of life but there is something else to consider that may not cause any symptoms at all and that is osteoporosis. Osteoporosis is a disease characterized by weak and brittle bones that are more likely to fracture, it is often called a silent disease affecting men and women of any age, but most commonly affects post-menopausal women. Often, there are often no symptoms until a bone breaks.

Besides being a post-menopausal female, there are other risk factors for developing osteoporosis, or osteopenia, which occurs when bones are weaker than normal, but not to the point of osteoporosis. These risk factors include increased age, ethnicity (Caucasian, Asian), low weight, previous fracture(s) before the age of 45, current cigarette smoking, excessive alcohol use and rheumatoid arthritis. Inactivity, low calcium and vitamin D intake, previous cigarette smoking, recurrent falls and certain medications (heparin, corticosteroids like prednisone, certain seizure medications and excessive thyroid supplementation) can also lead to osteoporosis.

If osteoporosis is a silent disease, how do you know if you have it? The most common way to screen for osteoporosis is to have a bone mineral density (BMD) test using a DXA (dual-energy x-ray absorptiometry) scan. The images of your bones are compared to images of bones of a healthy young adult of the same sex. You are given a T-score based on this comparison. The T-score determines whether your bones are normal, osteopenic, or osteoporotic:
• Normal Bones: T-Score 0 to -1 • Osteopenia: T-score -1.1 to -2.4 • Osteoporosis: T-score -2.5 or less

As a female, you should talk to your health care provider about having your BMD tested if you are post-menopausal and under age 65 with one or more risk factors; age 65 or older, regardless of risk factors; or age 50 or older with fracture history.

If you are diagnosed with osteoporosis, how is it treated? There are currently five different types of medications available to manage osteopenia and osteoporosis (see table below). All of these medications are available by prescription only and it is up to you and your healthcare provider to determine if treatment is necessary and which treatment is right for you. Regardless of treatment, it is important that everyone follow a bone healthy lifestyle. This includes regular weight-bearing exercise, reduced alcohol and caffeine intake, smoking cessation, fall prevention measures and adequate calcium and vitamin D intake.

Jill Hiers, Pharm.D, BCPS, is a clinical pharmacist with the Elliot Medication Clinical Services. Jill consults with patients within the Elliot Physician Network for Medication Therapy Management. She also meets regularly with patients for osteoporosis education and support. Jill received her Doctor of Pharmacy degree at the University of Connecticut. She recently became a Board Certified Pharmacotherapy Specialist in December, 2009. For more information, please contact her at (603) 663-7027. For more information about the Elliot Hospital visit their website at www.elliothospital.com

For more articles by this author or articles on different topics visit the Applaud Women Library.