Although the process of bone loss begins gradually when we are in our mid to late thirties, it is so slow that it may take many years before we become aware of it. Women, generally, are at greater risk of developing osteoporosis than men develop. This is because, following the menopause, women experience a rapid loss of bone from the skeleton due to the decrease in estrogen production.

Bone loss is usually a painless process until a fracture occurs. Thus, women often are unaware that they have osteoporosis until it is brought to their attention ,suddenly, with an unexpected and painful fracture, when they are in their fifties, sixties, or seventies. The most common way that a woman may discover that she has osteoporosis is when she breaks her wrist or hip following a minor fall. Other women, as they grow older , may find themselves losing height or developing a hunched back (“ dowager’s hump”) or find that their clothes no longer fit properly. This occurs when the vertebrae– the bones that make up the spine- become so weak that a simple daily movement such as coughing or lifting may cause them to collapse. This , too, can be extremely painful. Osteoporotic fractures, particularly those of the hip and spine, often lead to significant pain and disability. Although a fracture of the wrist often will heal with little residual deformity, a patient may not make a complete recovery from a fractured hip or spine. The resulting disability may affect the individual’s ability to work and care for her family and may be so severe that she becomes dependent on family members or community caregivers.

After the menopause, almost all women are at increased risk of osteoporosis, although certain lifestyle, hereditary, or medical factors may increase your risk of developing osteoporosis and the lifestyle changes that you can make to reduce this risk. If necessary, your physician will discuss with you further options that are available to you to prevent and treat osteoporosis.

Who is at risk of developing osteoporosis ?
It is a fact of life that, as we grow older, our bones become thinner and weaker. In theory, therefore , we are all at risk of developing osteoporosis. Certain factors may accelerate this process, however, and it is important that we become aware of them.

Menopause
Women are at greater risk of developing osteoporosis than men. Of course, this does not mean that every woman will get osteoporosis, simply that osteoporosis occurs with greater frequency in women.

After the menopause, the ovaries stop producing the female hormone, estrogen. Estrogen is important for maintaining bone strength. Without estrogen, bone loses calcium- one of its most important components. If you have had a particularly early menopause (before the age of 45, for example), your bones will have lost the important benefits of estrogen much earlier than usual, and it is likely that you are at an increased risk of developing osteoporosis.

The amount of estrogen in your body may also decrease due to reasons other than the menopause. If, for example, you have had a hysterectomy, and if your ovaries were removed, you are likely to have a very low estrogen level, and your risk of osteoporosis may be higher than normal.

Women whose periods have stopped for a long time, for any reason other than pregnancy, may have weaker bones as a result of having a deficiency of estrogen during that time. If you are still having regular periods, your ovaries probably are producing enough estrogen.