Osteoporosis: What teens, adults, pregnant or breastfeeding women should do | Health - Hindustan Times
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Osteoporosis: Here's what teens, young adults, pregnant or breastfeeding women should do

ByZarafshan Shiraz, New Delhi
Oct 14, 2023 08:40 AM IST

Health expert explains everything about osteoporosis - the risk, time for action and what should teens, young adults, pregnant or breastfeeding women should do

Females face a higher likelihood of developing osteoporosis and experiencing fractures and while out of the estimated 36 million individuals in India with osteoporosis, around 28 million or 80% are women, studies reveal that 1 out of every 2 women above the age of 50 will suffer a bone fracture due to osteoporosis. According to health experts, the risk of hip fractures for women is equivalent to their combined risk of breast, uterine and ovarian cancer.

Osteoporosis: Here's what teens, young adults, pregnant or breastfeeding women should do (Shutterstock)
Osteoporosis: Here's what teens, young adults, pregnant or breastfeeding women should do (Shutterstock)

Causes:

In an interview with HT Lifestyle, Dr Ashish Dewan, Consultant Orthopedic Surgeon at Apollo Spectra in Delhi, revealed, “Numerous factors contribute to women's increased susceptibility to osteoporosis compared to men, such as having smaller and thinner bones than men. Additionally, the hormone estrogen, which safeguards bones in women, significantly decreases during menopause, leading to bone loss. Consequently, the chances of developing osteoporosis escalate as women approach menopause. There is a better understanding of how to prevent, identify, and manage the disease. Regardless of your age, it is never too late or too early to prioritize bone health. By adopting healthy lifestyle practices, you can safeguard your bones and reduce the risk of developing osteoporosis. If your doctor has not discussed your bone health with you, it is important for you to initiate the conversation.”

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What’s Your Risk?

According to Dr Ashish Dewan, the risk of osteoporosis and bone health problems differs among girls and women based on their age and ethnic background where while older women face the highest risk, other groups also commonly experience osteoporosis and low bone density. Furthermore, it is not just women who are susceptible; men can also develop osteoporosis.

Menopause: A Time for Action

Given that upon reaching menopause, women experience a decline in estrogen levels which contributes to a reduction in bone density, Dr Ashish Dewan explained, “The severity and speed of this bone loss vary among individuals, with some women experiencing rapid deterioration. The probability of developing osteoporosis is influenced by two primary factors: initial bone mass at menopause and the rate at which bones are lost thereafter. Women with higher initial bone density have a lower risk of osteoporosis, whereas those with low peak bone mass or other risk factors face an increased chance of developing this condition. Furthermore, faster rates of post-menopausal bone loss elevate the likelihood of osteoporosis development.”

What about taking estrogen?

Dr Ashish Dewan elaborated, “If you are having menopausal symptoms like hot flashes, your doctor might suggest estrogen therapy (ET) or a combination of estrogen and progesterone hormone therapy (HT). These treatments not only alleviate symptoms but also aid in preventing bone loss. However, it is crucial to note that there are potential risks associated with ET or HT, including breast cancer, strokes, heart attacks, blood clots, and cognitive decline. Therefore, it is essential to have a detailed discussion with your healthcare provider about the advantages and disadvantages of each treatment option.”

Teens: What You Can Do Now

Pointing out that weak bones are most commonly associated with osteoporosis - a disease that predominantly affects older individuals, particularly women - Dr Ashish Dewan highlighted that nevertheless, there is no inevitability that this condition will afflict you as you age. He said, “Unlike the limitations imposed by ageing, you currently possess a unique opportunity to actively enhance bone density and strength. By seizing this chance to invest in your bone health now, not only will it contribute to overall well-being but it will also establish a foundation for resilient bones in later years when their vulnerability becomes critical. Achieving optimal bone health can be accomplished through a simple recipe: ensuring adequate intake of calcium and vitamin D while maintaining a balanced diet, engaging in regular physical activity as well and abstaining from smoking or excessive alcohol consumption.”

Young Adult Women

Dr Ashish Dewan asserted, “Despite being more prevalent among older individuals, osteoporosis can occasionally affect young people as well, including premenopausal women aged 20 to 40. Premenopausal refers to women who are still experiencing regular menstrual cycles and have not yet undergone menopause. Although osteoporosis is uncommon in this age group, some young women may exhibit low bone density, increasing their susceptibility to developing osteoporosis later on.”

Low Bone Density and Osteoporosis in Young Adult Women

“Young women with low bone density are more likely to develop osteoporosis in the future, either due to low peak bone mass or underlying medical conditions or medications that cause bone loss. In some cases, premenopausal women may have osteoporosis without any known cause, which is referred to as idiopathic osteoporosis,” Dr Ashish Dewan shared.

He advised, “Pregnant or breastfeeding women must prioritise their intake of calcium and vitamin D as these nutrients play a vital role in the development of both their own bones and those of their babies. Insufficient consumption of these essential elements can result in the baby drawing calcium from the mother's bones. Although there might be some degree of bone loss during pregnancy, research indicates that such loss is typically reversible after childbirth. Pregnancy-associated osteoporosis is an uncommon occurrence that affects certain women temporarily during gestation but generally disappears shortly after delivery.”

He concluded, “While breastfeeding can also lead to a temporary reduction in bone density, evidence suggests that it recovers over time without causing any lasting damage to a woman's bone health. It is imperative for all pregnant or nursing women to ensure they obtain adequate amounts of calcium, and vitamin D and engage in suitable physical activity to promote optimal bone health. For those exclusively breastfeeding their infants, seeking advice from the child's pediatrician regarding supplemental vitamin D is recommended.”

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