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									                                                                      Frequently Asked questions

                              Osteoporosis                                                                    I used to think that
                                                                                                              women don’t have
                                                                                                              to worry about frail
                                                                                                              bones until they get
                              Q: What is osteoporosis?
                                                                                                              older. I was wrong!
                              A:	 Osteoporosis	(OS-tee-oh-poh-ROH-                                            I found out too late
                                  sis)	is	a	disease	of	the	bones.	People	                                     that women of all ages
                                  with osteoporosis have bones that are                                       need to take steps to
                                  weak and break easily.                                                      help keep their bones
                                  A broken bone can really affect your                  strong. Sadly, like me, millions of women
                                  life. It can cause severe pain and dis-               already have or are at risk for osteopo-
         1-800-994-9662           ability. It can make it harder to do daily            rosis. Some days I have a hard time doing
  TDD: 1-888-220-5446             tasks on your own, such as walking.                   the things I want to without help. But I still
                                                                                        try to do what I can to keep my bones as
                              Q: What bones does osteoporosis                           strong as they can be. I make sure to get
                                 affect?                                                enough calcium and vitamin D, and I try
                                                                                        to walk with my neighbor in the mornings.
                              A: Osteoporosis affects all bones in the
                                                                                        I also talked to my doctor about taking
                                  body.	However,	breaks	are	most	com-
                                                                                        medicine to help.
                                  mon in the hip, wrist, and spine, also
                                  called	vertebrae	(VUR-tuh-bray).	
                                  Vertebrae	support	your	body,	helping	                    ture in this area occurs from day-to-day
                                  you to stand and sit up. See the pic-                    activities like climbing stairs, lifting
                                  ture below.                                              objects, or bending forward. Signs of
                                  Osteoporosis in the vertebrae can cause                  Osteoporosis:
                                  serious problems for women. A frac-              	       •	 Sloping	shoulders
                                                                                   	       •	 Curve	in	the	back
                                  Osteoporosis in the vertebrae                    	       •	 Height	loss
                                                                                	   •	 Back	pain
                                                                               Osteoporosis in the Vertebrae
                                                                                	   •	 Hunched	posture
                                                                                 	     •	 Protruding	abdomen
                                                                               Osteoporosis in the vertebrae can cause
                                                                               serious problems for women. A fracture in
                                                                               this area occurs from day-to-day activities
                                                                                 Q: What increases my
                                                                               like climbing stairs, lifting objects, orchances   of
                                                                               bending forward. osteoporosis?
                                                                                   A: There are several risk factors that raise
                                                                                   Sloping shoulders
                                                                               ●            your chances
                                                                                       Curve in the back of developing osteoporosis.
                                                                               ●            Some
                                                                                       Height loss of these factors are things you can
                                                                               ●       Backcontrol, while some you can’t control.
                                                                                       Hunched posture
                                                                                            Factors that you can’t control:

                                                                               ●       Protruding abdomen
                                                                                   	       •	 Being	female
                   page 1                                                          	       •	 Having	a	small,	thin	body	(under	
                                                                                              127 pounds)
                                     Healthy spine            Osteoporosis

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                       Frequently Asked questions

                              	       •	 Having	a	family	history	of	osteopo-         	      •	 Loss	in	height,	developing	a	
                                         rosis                                                 slumped or hunched posture,
                              	       •	 Being	over	65	years	old                               or	onset	of	sudden	unexplained	
                                                                                               back pain.
                              	       •	 Being	white	or	Asian,	but	African	
                                         American	and	Hispanic/Latina	               	      •	 You	are	over	age	45	or	a	post-
                                         women are also at risk                                menopausal and you break a bone.

                              	       •	 Not	getting	your	period	(if	you	
                                         should be getting it)                    Q: How can I find out if I have weak
                              	       •	 Having	anorexia	nervosa
http://www.womenshealth.gov                                                       A: There are tests you can get to find out
                              	       •	 Not	getting	enough	exercise                     your bone density. This is related to how
                              	       •	 Long-term	use	of	certain	medicines,	            strong or fragile your bones are. One test
  TDD: 1-888-220-5446                                                                    is called dual-energy X-ray absorptiom-
                                                                                         etry	(DXA).	A	DXA	scan	takes	X-rays	
                                  	      •	 Glucocorticoids	(GLOO-koh-
                                                                                         of your bones. Talk with your doctor or
                                            KOR-ti-koids)	—	medicines	
                                                                                         nurse about this.
                                            used to treat many illnesses,
                                            including arthritis, asthma, and
                                            lupus                                 Q: When should I get a bone den-
                                  	      •	 Some	antiseizure	medicines                sity test?
                                                                                  A:	 If	you	are	age	65	and	older,	you	should	
                                  	      •	 Gonadotropin	(GOH-nad-oo-                    get	a	bone	density	test.	Women	age	60	
                                            TROO-pin)	-releasing	hormone	                to	64	with	risk	factors	for	osteoporosis	
                                            —	used	to	treat	endometriosis	               and	women	over	45	who	have	broken	
                                            (en-doh-mee-tree-O-sis)                      any bones should also get tested. If you
                                  	      •	 Antacids	with	aluminum	—	the	                are	age	40	to	60,	you	should	discuss	
                                            aluminum blocks calcium absorp-              risk factors and testing with your doc-
                                            tion                                         tor or nurse.
                                  	      •	 Some	cancer	treatments
                                  	      •	 Too	much	replacement	thyroid	         Q: How can I prevent weak bones?
                                            hormone                               A: The best way to prevent weak bones is
                                                                                         to	work	on	building	strong	ones.	No	
                                      Factors that you can control                       matter how old you are, it is never too
                              	       •	 Smoking                                         late	to	start.	Building	strong	bones	dur-
                              	       •	 Drinking	too	much	alcohol.	Experts	             ing childhood and the teen years is one
                                         recommend no more than 1 drink a                of the best ways to keep from getting
                                         day for women.                                  osteoporosis later. As you get older,
                                                                                         your bones don’t make new bone fast
                              	       •	 A	diet	low	in	dairy	products	or	other	
                                                                                         enough to keep up with the bone loss.
                                         sources	of	calcium	and	vitamin	D
                                                                                         And after menopause, bone loss hap-
                              	       •	 Not	getting	enough	exercise                     pens	more	quickly.	But	there	are	steps	
                                      You may also develop symptoms that                 you can take to slow the natural bone
                                      are warning signs for osteoporosis. If             loss with aging and to prevent your
                   page 2             you develop the following, you should              bones from becoming weak and brittle.
                                      talk to your doctor about any tests or
                                      treatment you many need:

                                           U.S. Department of Health and Human Services, Office on Women’s Health
                                                                  Frequently Asked questions

                                 1. Get enough calcium each day.                The calcium amounts of these foods
                                 Bones	contain	a	lot	of	calcium.	It	is	         are	taken	from	the	United	States	
                                 important to get enough calcium in             Department	of	Agriculture’s	Dietary
                                 your diet. You can get calcium through         Guidelines for Americans.
                                 foods	and/or	calcium	pills,	which	you	         2. Get enough vitamin D each day.
                                 can get at the grocery store or drug           It is also important to get enough vita-
                                 store.	Getting	calcium	through	food	is	        min	D,	which	helps	your	body	absorb	
                                 definitely better since the food provides      calcium	from	the	food	you	eat.	Vitamin	
                                 other nutrients that keep you healthy.         D	is	produced	in	your	skin	when	it	is	
                                 Talk with your doctor or nurse before          exposed	to	sunlight.	You	need	10	to	15	
                                 taking calcium pills to see which kind is      minutes of sunlight to the hands, arms,
                                 best for you. Taking more calcium pills        and face, two to three times a week to
                                 than recommended doesn’t improve               make	enough	vitamin	D.	The	amount	
  TDD: 1-888-220-5446            your bone health. So, try to reach these       of time depends on how sensitive your
                                 goals through a combination of food            skin is to light. It also depends on your
                                 and supplements.                               use of sunscreen, your skin color, and
                                 Here’s	how	much	calcium	you	need	              the amount of pollution in the air. You
                                 each day.                                      can	also	get	vitamin	D	by	eating	foods,	
                                                                                such as milk, or by taking vitamin pills.
                                   Daily Calcium Requirements                   Vitamin	D	taken	in	the	diet	by	food	or	
                              Ages          Milligrams(mg) per day              pills is measured in international units
                              9-18                   1,300                      (IU).	Look	at	the	pill	bottle	or	food	
                                                                                label	for	the	IU	amount.
                              19-50                  1,000
                              51 and older           1,200                      Here’s	how	much	vitamin	D	you	need	
                                                                                each day:
                                 Pregnant	or	nursing	women	need	
                                 the same amount of calcium as other             Daily Vitamin D Requirements
                                 women of the same age.                      Ages                IU per day
                                 Here	are	some	foods	to	help	you	get	        19-70                  600
                                 the	calcium	you	need.	Check	the	food	       71+                    800
                                 labels for more information.
                                                                                Although it’s difficult to get enough
                                       Foods Containing Calcium                 vitamin	D	through	food,	here	are	some	
                              Food               Portion Milligrams             foods	that	can	help.	Check	the	food	
                                                                                labels for more information.
                              Plain, fat free      1 cup       452
                              yogurt                                                Foods Containing Vitamin D
                              Milk (fat-free)      1 cup       306           Food               Portion      IU
                              Milk (1 percent      1 cup       290           Salmon, cooked     3 1/2 oz     360
                                                                             Milk, vitamin D     1 cup        98
                              Tofu with added     1/2 cup      253           fortified
                                                                             Egg (vitamin D is  1 whole       20
                              Spinach, frozen     1/2 cup      146           in the yolk)
                   page 3     White beans,        1/2 cup      106

                                      U.S. Department of Health and Human Services, Office on Women’s Health
                                                                  Frequently Asked questions

                                  These	foods	and	IU	counts	are	from	the	        one alcoholic drink per day. Alcohol
                                  National	Institutes	of	Health	Office	on	       can make it harder for your body to use
                                  Dietary	Supplements.                           the calcium you take in. And, impor-
                                  White milk is a good source of vitamin         tantly, too much at one time can affect
                                  D,	most	yogurts	are	not.                       your balance and lead to falls.
                                  3. Eat a healthy diet.                         7. Make your home safe.
                                  Other	nutrients	(like	vitamin	K,	vita-         Reduce	your	chances	of	falling	by	
                                  min	C,	magnesium,	and	zinc,	as	well	           making	your	home	safer.	Use	a	rubber	
                                  as protein) help build strong bones too.       bath mat in the shower or tub. Keep
                                  Milk has many of these nutrients. So do        your	f loors	free	from	clutter.	Remove	
                                  foods like lean meat, fish, green leafy        throw rugs that may cause you to trip.
         1-800-994-9662           vegetables, and oranges.                       Make sure you have grab bars in the
                                                                                 bath or shower.
  TDD: 1-888-220-5446             4. Get moving.
                                  Being	active	helps	your	bones	by:              8. Think about taking medicines to
                                                                                 prevent or treat bone loss.
                              	   •	 Slowing	bone	loss
                                                                                 Talk with your doctor or nurse about
                              	   •	 Improving	muscle	strength                   the risks and benefits of medicines for
                              	   •	 Helping	your	balance                        bone loss.

                                  Do	weight-bearing	physical	activity,	
                                  which is any activity in which your        Q: How can I help my daughter
                                  body works against gravity. There are         have strong bones?
                                  many things you can do:                    A: Act now to help her build strong bones
                              	   •	 Walk                                        to	last	a	lifetime.	Girls	ages	9-18	are	
                                                                                 in their critical bone-building years.
                              	   •	 Dance                                       Best	Bones	Forever!™	(http://www.
                              	   •	 Run                                         bestbonesforever.gov) is a national edu-
                                                                                 cation effort to encourage girls ages
                              	   •	 Climb	stairs
                                                                                 9-14	to	eat	more	foods	with	calcium	
                              	   •	 Garden                                      and	vitamin	D	and	get	more	physical	
                              	   •	 Jog                                         activity. There is also a Web site for
                                                                                 the	parents	available	at	http://www.
                              	   •	 Hike                                        bestbonesforever.gov/parents.	This	site	
                              	   •	 Play	tennis                                 gives parents the tools and information
                              	   •	 Lift	weights                                they need to help their daughters build
                                                                                 strong bones during the critical window
                              	   •	 Yoga                                        of	bone	growth	—	ages	9-18.
                              	   •	 Tai	chi
                                  5. Don’t smoke.                            Q: What if dairy foods make me
                                  Smoking raises your chances of getting        sick or I don’t like to eat them?
                                  osteoporosis. It harms your bones and         How can I get enough calcium?
                                  lowers the amount of estrogen in your      A: If you’re lactose intolerant, it can be
                                  body.	Estrogen	is	a	hormone	made	by	           hard	to	get	enough	calcium.	Lactose	is	
                                  your body that can help slow bone loss.        the sugar that is found in dairy products
                   page 4
                                  6. Drink alcohol moderately.                   like	milk.	Lactose	intolerance	means	
                                  If you drink, don’t drink more than

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions

                                  your body has a hard time digest-               pregnant woman isn’t getting enough
                                  ing foods that contain lactose. You             calcium, she may lose a little from her
                                  may have symptoms like gas, bloating,           bones, making them less strong. So,
                                  stomach cramps, diarrhea, and nausea.           pregnant women should make sure
                                  Lactose	intolerance	can	start	at	any	age	       they are getting the recommended
                                  but often starts when you get older.            amounts	of	calcium	and	vitamin	D.	
                                  Lactose-reduced	and	lactose-free	prod-          Talk to your doctor about how much
                                  ucts are sold in food stores. There’s a         you should be getting.
                                  great variety, including milk, cheese,
                                  and ice cream. You can also take pills or   Q: Will I suffer bone loss during
http://www.womenshealth.gov       liquids before eating dairy foods to help      breastfeeding?
         1-800-994-9662           you digest them. You can buy these          A: Although bone density can be lost dur-
                                  pills at the grocery store or drug store.       ing breastfeeding, this loss tends to be
  TDD: 1-888-220-5446
                                  Please	note:	If	you	have	symptoms	of	           temporary. Several studies have shown
                                  lactose intolerance, see your doctor or         that when women have bone loss dur-
                                  nurse. These symptoms could also be             ing breastfeeding, they recover full bone
                                  from a different, more serious illness.         density	within	six	months	after	weaning.
                                  People	who	are	lactose	intolerant	or	
                                  who	are	vegans	(eat	only	plant-based	
                                  foods) can choose from other food
                                                                              Q: How is osteoporosis treated?
                                  sources of calcium, including canned        A: If you have osteoporosis, you may need
                                  salmon	with	bones,	sardines,	Chinese	           to make some lifestyle changes and also
                                  cabbage, bok choy, kale, collard greens,        take medicine to prevent future frac-
                                  turnip greens, mustard greens, broc-            tures.	A	calcium-rich	diet,	daily	exer-
                                  coli, and calcium-fortified orange juice.       cise, and drug therapy are all treatment
                                  Some cereals also have calcium added.           options.
                                  You can also take calcium pills. Talk to        These different types of drugs are
                                  your doctor or nurse first to see which         approved for the treatment or preven-
                                  one is best for you.                            tion of osteoporosis:
                                                                              	   •	 Bisphosphonates	(bis-fos-fo-nates)	
                              Q: Do men get osteoporosis?                            —	Bisphosphonates	are	approved	for	
                              A:	 Yes.	In	the	U.S.,	over	two	million	men	            both prevention and treatment of
                                  have	osteoporosis.	Men	over	age	50	are	            postmenopausal	osteoporosis.	Drugs	
                                  at greater risk. So, keep an eye on the            in this group also can treat bone loss,
                                  men in your life, especially if they are           and in some cases, can help build
                                  over	70	or	have	broken	any	bones.                  bone mass.
                                                                              	   •	 SERMs	—	A	class	of	drugs	called	
                                                                                     estrogen	agonists/antagonists,	com-
                              Q: How will pregnancy affect my
                                                                                     monly referred to as selective estro-
                                                                                     gen	receptor	modulators	(SERMs)	
                              A: To grow strong bones, a baby needs a                are approved for the prevention and
                                  lot of calcium. The baby gets his or her           treatment of postmenopausal osteo-
                                  calcium	from	what	you	eat	(or	the	sup-             porosis. They help slow the rate of
                                  plements you take). In some cases, if a            bone loss.
                   page 5

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                      Frequently Asked questions

                              	     •	 Calcitonin (kal-si-TOE-nin)	—	                	      •	 Take	the	lowest	possible	dose	of	
                                       Calcitonin	is	a	naturally	occurring	                    MHT	for	the	shortest	time	to	
                                       hormone that can help slow the rate                     meet treatment goals.
                                       of bone loss.                                 	      •	 Talk	about	using	other	osteopo-
                              	     •	 Menopausal Hormone Therapy                              rosis medications instead.
                                       (MHT)	—	These	drugs,	which	are	           	       •	 Parathyroid Hormone or
                                       used to treat menopausal symp-                       Teriparatide	(terr-ih-PAR-a-tyd)		
                                       toms, also are used to prevent bone                  —	Teriparatide	is	an	injectable	form	
                                       loss.	But	recent	studies	suggest	that	               of human parathyroid hormone. It
                                       this might not be a good option for                  helps the body build up new bone
http://www.womenshealth.gov            many	women.	The	Food	and	Drug	                       faster than the old bone is broken
         1-800-994-9662                Administration	(FDA)	has	made	the	                   down.
                                       following recommendations for tak-
  TDD: 1-888-220-5446                                                                    Your doctor can tell you what treat-
                                       ing	MHT:
                                                                                         ments might work best for you. n

                                  For more information
                                  You	can	find	out	more	about	osteoporosis	by	contacting	womenshealth.gov	at	1-800-
                                  994-9662	or	the	following	organizations:

                                  NIH Osteoporosis and Related Bone              U. S. Food and Drug Administration
                                  Diseases — National Resource Center            Phone:	(888)	463-6332
                                  Phone:	(800)	624-2663                          Internet	Address:	http://www.fda.gov
                                  Internet	Address:	http://www.niams.nih.
                                  gov/Health_Info/bone/default.asp               National Institute on Aging
                                                                                 Phone:	(800)	222-2225
                                  National Institute of Arthritis and            Internet	Address:	http://www.nia.nih.gov/
                                  Musculoskeletal and Skin Diseases
                                  Phone:	(877)	226-4267                          National Osteoporosis Foundation
                                  Internet	Address:	http://www.niams.nih.        Phone:	(877)	868-4520
                                  gov/	                                          Internet	Address:	http://www.nof.org/

                                      Reviewed by:
                                      Joan	A.	McGowan,	Ph.D.			
                                      Director,	Division	of	Musculoskeletal	Diseases
                                      National	Institute	of	Arthritis	and	Musculoskeletal	and	Skin	Diseases
                                      National	Institutes	of	Health

                                      All	material	contained	in	this	FAQ	is	free	of	copyright	restrictions,	and	may	be	copied,	
                                      reproduced,	or	duplicated	without	permission	of	the	Office	on	Women's	Health	in	the	
                                      Department	of	Health	and	Human	Services.	Citation	of	the	source	is	appreciated.
                   page 6
                                      Content	last	updated	January	1,	2007

                                         U.S. Department of Health and Human Services, Office on Women’s Health

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