Osteoporosis

Osteoporosis is a condition where your bones become weak and easily fractured. Older women who have reached menopause are at higher risk of developing osteoporosis due to low estrogen levels. 
Most women do not have symptoms of osteoporosis and may only be diagnosed after they get a fracture.

Do I need to get tested for osteoporosis?

Yes, if you are a menopausal female aged 65 years and above. If you are below 65 years old with risk factors for osteoporosis, you should also get screened. 

What are the risk factors for osteoporosis?

• Smoking
• Excessive alcohol drinking
• Low body mass index 
• History of low-trauma fracture for yourself or your parents, or family history of osteoporosis 
• Long-term steroid use e.g. steroids for rheumatoid arthritis
• Premature ovarian insufficiency (POI)
• Medical conditions e.g. diabetes, poorly controlled hyperthyroidism, etc 

What tests do I need to diagnose osteoporosis?

There are online tools that are helpful: 

• “Fracture Risk Assessment Tool”/FRAX, which estimates your 10-year likelihood of having a low-trauma fracture 
• “Osteoporosis Self-Assessment Tool for Asians”/OSTA, which compares your weight against your age and estimates your risk of getting osteoporosis.

The most accurate and commonly performed test is bone mineral density (BMD) test – this involves X-ray of the hip and spine and will be able to tell if you have osteopenia (low bone mass but not yet developed osteoporosis) or osteoporosis.

Your BMD test may need to be repeated:

• If your initial test was normal (this will usually be in about 10 years for monitoring)
• if your initial test shows that you have osteopenia (to check for worsening)
• if you have osteoporosis on treatment (to monitor your response to treatment)

What can I do to prevent osteoporosis?

• Healthy eating with sufficient calcium and vitamin D (from diet, supplements or both): for women who are not yet menopause, take 1000mg of calcium/day and 600IU vitamin D/day and for women who are menopause, take 1200mg of calcium/day and 800IU vitamin D/day
• Avoid smoking, alcohol and caffeine
• Weight-bearing exercise: examples include jogging, jumping, brisk walking, at least 3 times a week for 30 minutes each time 
• Avoiding falls: ensure good lighting, non-slip surfaces, no obstacles at home and outside. Check your vision regularly.

What is the treatment for osteoporosis?

This depends on your age, risk factors, BMD results (if any) and fracture risk. In general, treatment is recommended if you have an estimated 10-year risk of hip fractures ≥3% and major osteoporosis-related fractures ≥20%, or have already sustained an osteoporotic fracture. The most common treatment for osteoporosis is bisphosphonates – read more about them here.