- Question from Ruth: What is osteopenia and what can one do about it?
Osteopenia is a condition of less bone density or bone mass than would be normally expected if you compare a woman to a woman or population of women her age. Osteopenia is the bone loss that, as it continues, can lead to osteoporosis, which is when you've lost so much bone that your risk for fractures is significantly higher.
The symptoms of osteoporosis can be painful skeletal fractures, loss of height, and a higher risk of breaking bones. It's actually a common problem in women, especially those older than 65.
- Marisa C. Weiss, M.D. Dr. Shapiro, can you tell us a little more about how bone builds itself up and keeps itself strong over time.
All people, men and women, build bone mass up until age 35, and then bone mass starts declining. There are two kinds of bone loss. There's age-related bone loss, which means after age 35 you can actually lose a little bone each year. And there's also estrogen-related bone loss. Women have a heightened bone loss when they go through menopause, because it turns out that estrogen helps keep bone mass up, and when you transition through menopause, the estrogen levels go down. This situation leads to accelerated bone loss, which is why osteoporosis is a much bigger problem in women than men; although as men age and are living longer, some do experience significant bone loss.
Bone is a very active organ. It might be misleading because it's hard, but the bone is very metabolically active and there's a balance between cells that break down bone and cells that form new bone. Keeping that balance is a very carefully regulated process. In fact, that's one of the problems of space flight without gravity. Gravity influences the bones and mechanical stresses on the bones keep that balance normal. You lose bone in space because you're free from gravity and gravity's effect on the mechanical strength of bone.
- Marisa C. Weiss, M.D. I guess that's why weight-bearing exercise, getting gravity to help you, helps you keep your bones strong.
- Charles Shapiro And that's why it's important for the astronauts in Skylab to exercise!
On Wednesday, August 21, 2002, our Ask-the-Expert Online Conference was called Keeping Your Bones Strong. Charles L. Shapiro, M.D. and Marisa Weiss, M.D. answered your questions about how to measure the strength of your bones, how to find out your risk for osteoporosis, and what you can do to lower that risk.
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