Womens Health Curriculum:

OSTEOPOROSIS
Christine Bellantoni, M.D., M.P.H.

Definition
A systemic skeletal disease characterized by low bone mass and
microarchitectural deterioration of bone tissue, with a consequent increase in bone
fragility and susceptibility to fracture.
Fig.1. Normal Bone vs Osteoporotic Bone
Loss of trabecular plates (right) results in weakened bone structure significantly
increasing risk of fractures.

Epidemiology
10 million people have osteoporosis (8 mil women, 2 mil men)
18 million people or more have low bone mass
Most prevalent among postmenopausal woman but can occur at any age
Womans risk of fracture is equal to her combined risk of breast, uterine and
ovarian cancer
24% of hip fracture patients age 50 and older die in one year following fx
Only 1/3 fully regain their prefracture level of independence
Cost > $20 billion/yr

Fractures
1.5 million fx/yr
300,000 hip
700,000 vertebral
250,000 wrist
300,000 at other sites

Impact
Chronic pain
Height loss
Kyphosis
Decreased self-esteem
Restrictive lung dx
Constipation, abdominal pain
Depression

Risk Factors For Osteoporotic Fractures

Personal history of fracture as an adult

History of fracture in a first degree relative
Caucasian
Female
Low body weight (<127 lbs)
Estrogen deficiency
Early menopause (<age 45)

 Bilateral oopherectomy
Prolonged amenorrhea (>1 yr)

Hypogonadism in men
Alcoholism
Current cigarette smoking
Low calcium intake (lifelong)
Inadequate physical activity
Dementia
Recurrent Falls
Poor health/frailty

Classification
Primary
Postmenopausal
Decreased estrogen results in increased osteoclastic activity
without increased osteoblastic activity
Bone loss 2-3% per year of total bone mass
Most common fx: vertebral, distal forearm
Age related 3rd decade of life starts slow decline in bone mass at rate of
0.5-1% per year
Most common types of fx: hip and radius
F>M
Secondary
Secondary Osteoporosis
Disease states