What is osteoporosis?

Osteoporosis is a thinning and weakening of the bones that happens to all of us as we get older. If this deterioration in our bones goes untreated, our skeleton eventually will become extremely fragile, and some bones will be likely to break - or fracture - with very little trauma.

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. 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 this risk.