EmpowHer: Is it true that 80 percent of those affected by osteoporosis are women? Is that true or false?
Dr. Binkley: Eighty percent -— I think that number is a little high. It depends on what type of fracture you look at. Clearly, osteoporosis has been appropriately viewed as the disease of women in that the fracture risk, as I mentioned, is about 50 percent. However, I think we should recognize that this is not simply a disease of older women. If you look at a 50-year-old white man, his risk of having an osteoporotic fracture in his remaining lifetime is almost 25 percent.
EmpowHer: That is pretty high.
Dr. Binkley: Yes, this disease will affect approximately one in two women and approximately one in four in men. We need to increase the recognition that this is not solely a disease limited to women.
EmpowHer: And also it is important to note that women are often the health keepers of their male family members.
Dr. Binkley: Yes, you are exactly right there.
EmpowHer: Doctor, are women more likely to suffer from osteoporosis because as they age, they might be less active? Does activity level play a larger role?
Dr. Binkley: You are right that inactivity certainly contributes to a decline in bone mass and in bone strength. Inactivity also contributes to a decline in muscle strength which can make us more likely to fall, and obviously falls can cause broken bones. So inactivity is a major factor for both women and men. The reason that women are more likely to sustain osteoporotic fractures than men is that males in general are bigger than females; larger bones are stronger than smaller bones. So because male bones in general are larger than female bones, they tend to be stronger and therefore less likely to break. Additionally, women usually have a fairly abrupt decline in estrogen levels around the menopausal transition. In men, that decline tends to be slower after age 50. When you remove estrogen from women or testosterone from men, our bodies lose roughly 10 to 15 percent of our bone mass over the coming five years. So when women go through menopause, it is expected that their bone density will decline by a fairly substantial amount.
EmpowHer: That makes perfectly good sense. So how should osteoporosis patients advocate for themselves in the doctor’s office?
Dr. Binkley: I guess it depends on how you know you have osteoporosis. If you have a bone attack or a fracture with usual daily activity, that is basically a diagnostic of osteoporosis. I am not talking about fractures where a person has been in a car accident or falls off a ladder. If you put enough force on the bone, you can break it even if you are a professional football player. I am talking about non-traumatic fractures that occur with a fall from standing height or with lifting, particularly in folks over age 50. If, for example, a 65- or 70-year-old woman has had a spine or a wrist fracture, she is telling us that she has osteoporosis because she has had a bone attack. It is just like the person who has a heart attack; obviously there is a problem that needs to be addressed. In a perfect world, we would identify people before they manifest the disease.
EmpowHer: You bring up a really good point right there.
MORE ON DR. NEIL BINKLEY
For More Information on Dr. Binkley Visit Him on The Web:
http://www.sjo.org/Clinical_Services/Comprehensive_Breast_Center.aspx
Neil Binkley, M.D.
Dr. Binkley earned his MD degree from the University of Wisconsin Medical School and subsequently received his training in Internal Medicine at the Marshfield Clinic. After several years in private practice, he returned to the University of Wisconsin in 1990 and completed a geriatric fellowship. He is board certified in Internal Medicine and Geriatrics. In 1994 he was instrumental in establishing the UW Osteoporosis Clinical Center and the Osteoporosis Clinical Research Program, offering treatment options unavailable in standard clinical practice. Additionally, his research efforts focus on osteoporosis diagnosis, osteoporosis in men and the role of nutrition in bone loss. Recent studies of vitamins K and A are lending valuable data on nutritional supplementation and bone health. Dr. Binkley also serves on the scientific advisory committee and physician certification
course faculty for the International Society for Clinical Densitometry.