Osteoporosis is a chronic disease in which there is a loss of bone mass and destruction of bone tissue. This process causes weakening of the bones and makes them more likely to break. The bones most often affected are the hips, spine, and wrists. Risk Factors Osteoporosis affects more than 10 million Americans, with women four times more likely to develop it than men. Another 34 million have low bone mass, or osteopenia, and therefore have an increased risk for osteoporosis. Estrogen deficiency is one of the main causes of bone loss in women during and after menopause. Women may lose up to 20 percent of their bone mass in the five to seven years following menopause. Although the exact medical cause for osteoporosis is unknown, a number of factors may contribute: Aging: Bones become less dense and weaker with age. Race: Caucasian and Asian women are most at risk. Weight: Obesity is associated with a higher bone mass, so people who weigh less and have less muscle are more at risk for developing osteoporosis. Lifestyle factors: These include physical inactivity, caffeine consumption, excessive alcohol use, smoking, and dietary calcium and vitamin D deficiency. Certain medications Family history of bone disease Osteoporosis and Menopause In 2006, the North American Menopause Society (NAMS) reviewed and updated its guidelines on the diagnosis, prevention, and treatment of postmenopausal osteoporosis. NAMS suggests that women’s lifestyle practices should be reviewed regularly by their physicians, and a woman’s risk for falls should be evaluated at least once a year after menopause has occurred. NAMS also recommends that a woman’s height and weight should be measured annually, and she should be assessed for kyphoses (exaggerated rounding of the back) and back pain. Diagnostic Procedures and Tests Diagnostic procedures for osteoporosis may include a complete medical history, physical exam, skeletal X-rays, blood tests to measure serum calcium and potassium levels, and a bone density test (also called bone densitometry), which measures the mass of bone in relation to its volume. Bone densitometry testing is primarily performed to identify osteoporosis and osteopenia so that the right treatment can be implemented. Early treatment helps to prevent future bone fractures. It may also be recommended for people who have already fractured and are considered at risk for osteoporosis. The bone densitometry test determines your bone mineral density (BMD). Your BMD is compared to two norms: healthy young adults (your T-score) and age-matched (your Z-score). Treatment and Prevention In managing and treating osteoporosis, the goals are to decrease pain, prevent fractures, and minimize further bone loss. Some of the methods used to treat osteoporosis are also the methods to help prevent it from developing, including the following: Maintain an appropriate body weight. Increase walking and other weight-bearing exercises. Minimize caffeine and alcohol consumption. Stop smoking. Maintain an adequate intake of calcium through diet and supplements. Vitamin D is also necessary because it helps the absorption of calcium. Prevent falls in the elderly (for example, install hand railings or assistive devices in the bathroom, shower, etc.). Talk with your doctor about medication options.