The disease

Pathophysiology
Postmenopausal osteoporosis is promoted by estrogen deficiency. Other forms occur in the elderly of both sexes (formerly known as “senile osteoporosis”). Others are drug or endocrine origin (long-term steroid therapy, hyperthyroidism, hypogonadism, etc..).

Epidemiology
Bone loss and architectural deterioration increases with age. The first years of menopause is accompanied by significant bone loss in 30% of women.

Complications
The fracture characteristics of postmenopausal osteoporosis are those of the vertebrae, the upper end of the femur and wrist. They occur spontaneously or during minimal trauma. The major risk is that of femoral neck fracture in elderly.

1. Women, the main affected
Worldwide it is estimated that 200 million women suffer from the disease, and that at least one third of women over age 50 may suffer an osteoporotic fracture during their lifetime. If we add the population of Europe and the U.S., it is possible that more than 30 million women are affected by this disease.

In general, the risk of osteoporosis is lower in males, because they have higher rates of bone mass and thus bone loss that can withstand is also greater.

Males also have a lower life expectancy and not suffer a sudden reduction in sex hormones as well as a period of accelerated bone loss, as is the case in women during menopause.

However, other factors such as sedentary lifestyle, the snuff, excessive alcohol consumption, poor diet or use of steroid medication can also increase the risk of fractures in both men and women. In fact, 30% of all fractures occurring in males occurs.

2. Menopause and osteoporosis
The human body’s amazing ability to renew and heal itself guarantees that a perfect balance between the losses suffered and what heals. Just as they do the skin cells, bone is removed and renewed constantly, which keeps the skeleton strong and healthy.

In this process, known as “bone renewal, cells called osteoclasts adhere to the bone surface, remove a small area of old bone and create a cavity.

Immediately after this, appearing osteoblasts, which are cells that synthesize the same amount of new bone tissue had been removed by osteoclasts. This perfect balance is maintained.

However, in women approaching menopause, and after the commencement thereof, the balance between the removal and replacement of the bone is altered, and bone loss is greater than the renewal.

If this imbalance continues, the result is usually the presence of osteoporosis. Over time, women with osteoporosis can lose up to half of their bone mass (bone mineral density or BMD).

Studies have shown that a loss of only 10% of bone mass in the spine increases twice the risk of suffering a spinal fracture, and 10% mass loss at the hip increased by 2, 5 times’s the risk of suffering a hip fracture.

3. Factors influencing bone loss
Several factors may influence bone loss in women, among them include poor diet and lack of exercise. But a key factor in bone loss experienced by many women after menopause is a gradual loss of estrogen, which are hormones produced by the ovaries and, in addition to regular menstrual periods, play a key role in keeping the mass and resistance bone.

The most common osteoporotic fractures are the hip, wrist and spine. Spinal fractures are associated with a loss of height and curvature of the spine. Many spine fractures occur because some daily efforts, such as lifting the shopping bag, causing them to break the bones are already weakened.