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Osteoporosis

Osteoporosis is a condition in which bones lose mass, or density, and the bone tissue breaks down. As part of the aging process, bones slowly become weaker, more brittle and less dense. These changes mean they can break easily. The bones that have the highest risk of breaking because of osteoporosis include those in the hip, pelvis, spine, ribs, wrist and leg.

Causes

Osteoporosis can be caused by certain types of cancer such as multiple myeloma. It can also be caused by certain types of cancer treatments or their side effects.

Hormonal therapies may be used to treat breast, uterine, ovarian and prostate cancers. Some hormonal therapies block or lower the body’s production of certain hormones such as estrogen and testosterone. Estrogen is a female sex hormone made by the ovaries. Testosterone is a male sex hormone made by the testicles. These hormones play a role in keeping bones strong. Find out more about hormonal therapies.

Some cancer treatments cause early menopause, or treatment-induced menopause. These treatments include chemotherapy, surgery to remove both ovaries and radiation therapy to the pelvis. If the ovaries are removed or damaged, they can’t make estrogen or progesterone. This will result in less estrogen in the body, which will lead to weakened bones.

Some people with brain tumours need to take anticonvulsants to prevent seizures. People with brain and spinal cord tumours may also need to take corticosteroids, which are hormones that help reduce swelling and lower the body’s immune response. These drugs can also weaken the bones.

Symptoms

People can have osteoporosis for years without having any symptoms. A broken bone may be the first symptom of osteoporosis. Other symptoms include:

  • loss of height over time
  • stooped posture
  • rounding of the upper back, which is called kyphosis
  • bone tenderness or pain

If symptoms get worse or don’t go away, report them to your doctor or healthcare team without waiting for your next scheduled appointment. It is important to find osteoporosis early to help prevent fractures.

Diagnosis

Your doctor will try to find the cause of osteoporosis. It is usually diagnosed by:

  • bone density scan
  • x-rays
  • blood tests
  • urinalysis, or urine tests

Find out more about these tests and procedures.

Managing osteoporosis

Once the cause of osteoporosis is known, your healthcare team can suggest ways to manage it. There is no cure for osteoporosis, but the following measures can help prevent or control bone loss.

Osteoporosis Canada provides more information about osteoporosis and support for people living with this condition. Visit the Osteoporosis Canada website.

Maintain a healthy lifestyle

The body needs calcium and vitamin D to keep the bones strong. Try to eat more foods that have calcium and vitamin D, especially oily fish and milk products. Talk with your healthcare team about the suggested daily intake of calcium and vitamin D as recommended by Health Canada. They may also suggest taking calcium and vitamin D supplements if you aren’t getting enough through your diet. All sources of calcium and vitamin D must be included when adding up daily amounts, including diet and supplements. Visit the Health Canada website to find out more about their recommended vitamin D and calcium intakes.

Be physically active regularly to help keep your bones healthy. Physical activity includes weight-bearing exercises such as walking, jogging, dancing, playing tennis, climbing stairs and low-impact aerobics. You can also do strengthening exercises such as using free weights, weight machines, rowing machines and stretch bands. Try stretching or balancing exercises such as yoga and Tai Chi. Talk to your doctor about a specialized exercise program if you have been diagnosed with osteoporosis.

Stop smoking and limit how much alcohol you drink to maintain bone health.

Medicines

Your healthcare team may suggest certain medicines to help decrease bone loss and the risk of fractures. Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.

Bisphosphonates are drugs that strengthen bones and stop the natural process in which the body breaks down bone. Examples of bisphosphonates that may be used to prevent and treat osteoporosis include:

  • alendronate (Fosamax)
  • risedronate (Actonel)
  • etidronate (Didrocal, Didronel)

Raloxifene (Evista) is a drug that helps increase bone density. It is given to prevent and treat osteoporosis in post-menopausal women.

Hormone replacement therapy (HRT) is a treatment that replaces female sex hormones (estrogen, progesterone or both) when the ovaries no longer make them. HRT may be used to relieve the symptoms of menopause. It may also be used to prevent and treat osteoporosis. HRT has both risks and benefits. Talk to your doctor about how it might be used to treat osteoporosis.

Teriparatide (Forteo) is a drug that helps new bone to develop. It is used to treat severe osteoporosis or if you can’t tolerate other osteoporosis treatments. Doctors may also try it when other treatments don’t work.

Calcitonin is a hormone that helps maintain bone density. Calcitonin doesn’t prevent osteoporosis, but it may be used to treat it. It also helps relieve pain from fractures of the backbone, or vertebrae.

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