Bone Density Management

Gyn LA is a full-service medical practice that is committed to providing quality healthcare for women of all ages in and around the Los Angeles area. The team of medical professionals is skilled and highly trained with access to the most advanced medical techniques to undertake all types of treatments and surgeries concerning women’s health. The doctors and staff can help patients with early diagnosis of potential health problems, like bone density management and potential health issues during and after menopause, and then advise about the prevention and treatment procedures. A multidisciplinary patient-care team is dedicated to treating the patient’s condition through an integrative treatment plan that is specifically tailored to meet every patient’s unique medical condition.

Overview: Bone Density Management

Bones are living tissue and undergo break down and then rebuild new bone tissues again throughout your life. Bones provide structure, design, and support to your body, and there are no alternatives to strong and healthy bones.When old bone starts to break down at a faster rate than the rate at which new bone tissues are made, net bone loss occurs. This condition may lead to lower bone density (than normal) and weaker bones.

Bone density is defined by bone mineral content (BMC). The density the of bone establishes the strength of the bone. Low bone density puts you at a higher risk of experiencing bone breakage or fractures as compared to those with average bone density.During childhood and teenage years, you have the highest peak bone mass, which results in larger, heavier, and denser bones. The process slows down after the early 20s, and as people reach the mid-30s, they start to lose more bone mass than they make.The hard minerals in bone are replaced by empty honeycomb-like tissues, resulting in lighter and more fragile bones. Such a state increases the risk of developing osteoporosis and broken bones (fractures) even with nominal strain.

Unmanaged bone density may become a cause for developing osteoporosis. This chronic disease causes gradual bone weakening and is also often called a “silent disease” because bone loss generally occurs without any visible symptoms until you break a bone. The truth is, your bones had been losing strength all these years,but it only comes into notice when osteoporosis has already far advanced. Not everyone who has a low bone density gets osteoporosis, but the probability of getting it is high.

Osteoporosis-related risk factors, such as gender, age, family history, and race/ethnicity, are not in your control. However, other factors are under your control. These include exercise, diet, smoking, and drinking habits. Your bone health is most affected by the lifestyle and food habits you choose. Healthier choices can undoubtedly reduce the risk of osteoporosis as well as the pain of broken bones.

How to Measure Bone Density?

Bone density can be determined by a bone mineral density (BMD) test. The gold standard measurement of bone density is called dual-energy x-ray absorptiometry (DEXA or DXA) scan. This bone density scan can diagnose osteoporosis by estimating the density of bones as well as your chance of breaking a bone before a broken bone occurs. Reported by a numerical rating quantified as a "T-score," this DEXA test involves measuring bone density at the heel, hip, spine, hand, or wrist.In clinical medicine, the bone mineral density is treated as an indirect indicator of fracture risk (or osteoporosis).If the T-score rating is greater than -1.0, it is regarded as normal and indicates a healthy bone. A score in the range of -1.0 and -2.5 indicates a condition we call “osteopenia” and T-score below -2.5 means you haveosteoporosis.

If a person has osteoporosis, the test should be repeated every 1 to 2 years to check if the bones are still losing density or staying the same. A comparative study of the test results from the same doctor who knows your medical or family history may be a good choice. 

Bone Density and Women

According to an estimate by the International Osteoporosis Foundation, low bone density leading to osteoporosis affects around 200 million women across the world. Here are a few statistical facts to consider:

• An estimated 80 percent of the 10 million Americans with osteoporosis are women.
• One in every three women above age 50 is at risk of having an osteoporotic fracture in their lifetime as compared to one in five men.
• The risk of breaking a hip in women is in proportion to the combined risk of uterine, breast, and ovarian cancer.

Studies show that 5 to 20 percent of hip fractures in women cause death within one year, 20 percent suffer from severely impaired mobility, and 50 percent of women do not regain previous mobility. Experts say that although women patients consider hip fracture as a serious condition, they are unaware of the risk of osteoporosis.

All postmenopausal women aged 65 and above, regardless of additional risk factors should have a BMD test. On the other hand, women under age 65 but past the menopause stage should also consider such a test if they have undergone a bone fracture due to fragile or weak bones or have additional risk factors for osteopenia or osteoporosis. It is unfortunate that only 50 percent of the women who need bone density measurement and/or bone medication successfully get it during a primary care gynecological consultation.

Why are Women at a Higher Risk of Low Bone Density or Osteoporosis?

Reduced Estrogen Levels Post Menopause is another health issue in women that can be blamed for hormone changes. Two common female hormones—estrogen and progesterone—play a key role in keeping bones strong and healthy bones; however, after menopause, women experience a dramatic change in estrogen levels. This may lead to a higher probability of bone loss and osteoporosis. Within five years of menopause, some women can lose over 30 percent of their bone mass.

When you talk about estrogen levels, a lower bone density in women may occur due to irregular or infrequent menstrual periods, surgical removal of ovaries, or reaching menopause at an early age. A lack of estrogen can cause bone loss in younger women too.

Genetics. Women generally have a petite size and have thinner, smaller bones than men. After puberty age, bone mass in females tends to show lesser growth than males. Moreover,as women reach menopause, the bone breakdown overtakes the building of new bone, which results in a higher probability of females losing bone mineral density or develop osteoporosis. The risk of future bone fracture in women between 60 and 85 years is 50 percent!

Ethnic Background. Bone health in women also varies among women of different ethnicities. Older women and Caucasian (white) or Asian women are at the highest risk of low bone density and osteoporosis among other ethnic groups.

Low Bone Density in Young Adult Women. Young women in their 20s, 30s, and 40s who have low peak bone mass are at a higher risk of low bone density or getting osteoporosis in later years. While such risks are more common in older women (postmenopausal), it can develop in premenstrual women (still having menstrual periods) too, often due to an underlying medical condition or some medicine that causes bone loss. Sometimes, premenopausal women may also develop osteoporosis for unknown reasons, which we typically call “idiopathic” osteoporosis.

Other risk factors that will affect the risk of low bone density or developing osteoporosis in men and women include:

• Sedentary lifestyle
• Family history of osteoporosis
• Smaller body frame size
• Personal history of fracture as an adult
• Heavy smoking and/or excessive alcohol consumption
• Lack of calcium and/or vitamin D intake
• Use ofantiepileptics, heparin or thyroxine

No use of hormone therapy (HT) for the long-term may also be a reason for BMD assessment. When you are diagnosed with osteoporosis, you must consult with your doctor to see if you already have another condition triggering bone loss, referred to as secondary osteoporosis. In such situations, treating the other medical condition may help you with improving bone health.

Complications

Low bone density or osteoporosis leaves you at a higher risk of bone fractures in the hip or spine. Hip fractures caused by a sudden fall can result in disability or risk of death within a year after injury in some cases. Spinal fractures can occur with or without a fall. Low bone density can weaken your spine, often resulting in lost height, back pain, and a hunched forward posture.

Prevention and Treatment of Low Bone Density

The prevention and treatment of low bone mass or low bone density is three-pronged, which includes a healthy diet, exercise, and medication.

Exercise can play a crucial role in increasing bone mass pre-menopause and slows down the bone loss post-menopause. As per a recommendation by the Centers for Disease Control and Prevention, healthy adults are recommended to have at least 150 minutes of exercise every week, averaging about 30 minutes per day. Just like your muscles, your bones grow stronger with weight-bearing exercises, which are rated to push your body to function against the gravity, prompting the body to build new bone. Some of the weight-bearing exercises include jogging, brisk walking, climbing stairs, aerobics, yoga, running, and others. Strength training, such as lifting free weights, using wrist or ankle weights, doing pushups, squats, and others also help to build bone strength.Moreover, healthy lifestyle habits should be practiced not only for the bones but for the overall general health as well. It's never too late to improve your bone health, no matter what your age is.

A healthy diet can help build healthy bones, especially if it includes a high intake of calcium and vitamin D. Calcium is a mineral stored in bone and responsible for giving it hardness.Most women do not get an adequate amount of calcium from food, so they should eat more of foods rich in calcium content, such as green leafy veggies like kale, spinach, and collards; canned fish like sardines and salmon; dairy products like milk, yogurt, and cheese. On the other hand, vitamin D aids the body in the absorption of dietary calcium.Higher quantities of vitamin D can be found in oily fish, mushrooms, egg yolks, and fortified foods like orange juice, cow’s milk, and various breakfast cereals. Exposure to direct sunlight for 15 minutes on alternate days can also get you the needed vitamin D.

Various prescription medications are also available to manage your bone density and reduce the risk of fractures.The most prescribed medications are called bisphosphonates, and medical studies back the fact that they can help prevent broken bones by slowing down the body’s natural process for breaking down bones, especially in older (postmenopausal) women. These meds may keep women keep the level of bone they have and, in some cases, even provide a small boost to their bone density. However, there is little proof that bisphosphonates help women with pre-osteoporosis. Medications approved by the U.S. Food and Drug Administration (FDA) that help increase bone density and stop bone loss include Fosamax, Actonel, Evista, Boniva, Calcimar, Reclast, and Prolia. Medications for bone formulation include Forteo. Bone density test results should always be the deciding factor when it comes to taking medicines for bone density management.

Hormone replacement therapy may also help some women but comes with its share of side effects. If hormone replacement helps you with symptoms of menopause, your doctor may recommend that you keep taking it for the bone loss too. 

Find a Full-Service Practice Specializing in Bone Density Management Near Me

Gynecologists are most often the only doctors that postmenopausal women see on a regular basis and can play a role in diagnosis, prevention, and treatment of osteoporosis. If you or a loved one is experiencing severe back pain without apparent injury or fractures of hip, wrist or spine after a relatively mild trauma, the condition is indicative of low bone density and may lead to osteoporosis if not consulted with a specialist in a timely manner. A comprehensive, full-service medical care center for women like Gyn LA can provide the guidance and knowledge you need for bone density management. If you are living in and around Los Angeles, you can get in touch with us at 310-375-8446 and talk to one of our expert doctors to find answers to all your health-related questions.