Risk Factors for Osteoporosis

Estrogen Deficiencies

Estrogen deficiencies occur as a result of:

• ]]>Menopause]]>: Natural or surgical menopause increases your risk of osteoporosis. The risk of fracture increases significantly five years after menopause. Though initial fractures may be in the wrist or spine, these strongly predict the later development of severe osteoporosis and hip fracture.
• ]]>Amenorrhea]]> (cessation of menstruation before menopause): Your risk of osteoporosis increases if you miss menstrual periods for three months or longer. Amenorrhea may occur with eating disorders, such as ]]>anorexia nervosa]]> and ]]>bulimia]]> , or with excessive or intensive exercise, such as long distance running.

Hormonal Deficiencies

In men, deficiencies of testosterone and to a much minor extent, estrogen, play a role in the development of osteoporosis. This may be related to:

• Advanced age
• Certain medical conditions that reduce testosterone levels, such as ]]>mumps]]> or treatment for ]]>prostate cancer]]>
• Hypogonadism (a severe deficiency in the male sex hormone)

Dietary Factors

Your risk of developing osteoporosis increases if you do not get enough calcium or vitamin D in your diet. An excess of phosphorous in your diet may increase your risk if your calcium and/or vitamin D intakes are low. Excessive use of alcohol, coffee, or tea may also increase your risk of osteoporosis.

Lack of Exercise

Regular exercise, especially weight-bearing and resistance exercise, helps strengthen bones. Therefore, if you don’t exercise on a regular basis, you may increase your risk of developing osteoporosis. Individuals who don’t exercise regularly also tend to have weaker muscles and poorer balance, which can lead to falls and fractures.

Smoking

Smoking impairs bone, muscle, and joint health. If you smoke, you have a higher risk of developing osteoporosis.

Bone Structure and Body Weight

Small-boned women and underweight individuals of both sexes have an increased risk of osteoporosis. Individuals who are short, thin, and have narrow hips are at increased risk of low bone density and fracture.

Lack of Sunlight

The effect of sun on the skin is a primary source of vitamin D, which aids bone formation. If you get very little sun exposure and have a low dietary intake of vitamin D, you may be at increased risk of osteoporosis.

Ethnic Background

Asian and Caucasian women are more likely to develop osteoporosis than those of other ethnic groups. Though most ethnic studies have focused on women, it is believed that men in these ethnic groups carry a parallel but lower risk.

Medications

The long-term use of certain medications increases your risk of osteoporosis. Medications that increase bone loss include:

• Glucocorticoids, such as prednisone
• Immunosuppressants, such as methotrexate and cyclosporine
• Chemotherapy
• Excess thyroid replacement hormone
• Anticonvulsants, such as phenytoin
• Loop diuretics— A new study has shown that these might not be associated with bone loss. ]]>*²]]>
• Medications containing aluminum, such as some antacids
• Long-term heparin therapy
• Glitazones ]]>*¹]]>

These drugs are extremely important for treating serious and chronic conditions. Do not cut back or stop your medication on your own. Discuss your concerns with your doctor.

Chronic Diseases

Certain chronic diseases increase your risk for developing osteoporosis. They include:

• Liver disease, including ]]>cirrhosis]]>
• Kidney disease
• ]]>Diabetes mellitus]]>
• ]]>Hyperthyroidism]]>
• Scurvy (vitamin C deficiency)
• ]]>Alcoholism]]>
• Inherited disorders, including:
  • ]]>Marfan]]> and Ehler-Danlos syndromes
  • Porphyria
• ]]>Cushing’s syndrome]]>
• ]]>Hyperparathyroidism]]>
• Cancer, including lymphoma, leukemia, myeloma, and others
• Treatment for cancer, such as ]]>chemotherapy]]> or ]]>radiation]]> therapy
• Organ transplantation
• Gastrointestinal disorders, especially those causing malabsorption
• ]]>Sarcoidosis]]>

Diseases in Children

Children having certain diseases are at risk for low peak bone mass and, therefore, are at increased risk of developing osteoporosis later in life. Diseases and conditions that put children include:

• Premature birth
• ]]>Anorexia nervosa]]>
• ]]>Asthma]]> or other diseases that are treated with corticosteroid drugs
• Disorders that cause malabsorption such as:
  • ]]>Cystic fibrosis]]>
  • ]]>Inflammatory bowel disease]]>
  • ]]>Celiac disease]]>
• Hypogonadal (low hormone) states such as:
  • Delayed puberty
  • Delayed onset of periods in girls
  • Infrequent or no periods in girls

Depression

Major ]]>depression]]> is associated with increased risk of osteoporosis. This could possibly be due to higher levels of the stress hormone cortisol, which may contribute to loss of bone density.