Sticks and stones are not the only things that can break your bones. If you have osteoporosis, even a simple fall or bump may lead to a fracture.
Osteoporosis is a disease which decreases bone mass and strength due to an excessive loss of protein and mineral content, particularly calcium. Having weak and brittle bones can lead to debilitating and even life-threatening injuries.
Frederick Nicomedez, M.D., an orthopedist from St. Luke’s Medical Center in Global City, says most fractures occur along the spine, hip, and wrist area. He illustrates, “Having osteoporosis is like having a wooden structure with termite infestations. It becomes structurally unsound. When you put weight on it, it starts crumbling down.”
According to the International Osteoporosis Foundation (IOF), the condition is “greatly underdiagnosed and undertreated in Asia,” despite a projection that more than 50 percent of all osteoporotic hip fractures will occur in this region by the year 2050. Worldwide, osteoporosis is more common in women than in men.
Although there are several factors—genetic predisposition, age, lifestyle, diet—that can contribute to the condition, the disease is strongly linked to the body’s estrogen levels.
Estrogen is the female sex hormone which helps in the normal functioning of the reproductive system. It also helps the body absorb calcium, which is critical for bone development and maintenance.
An IOF fact sheet further expounds, “Hormones are possibly the most crucial modulators of bone formation. It is well-established that estrogen, parathyroid hormone, and to a lesser extent testosterone, are essential for optimal bone development and maintenance. Of these, estrogen is now believed to have the most direct effect on bone cells.”
This is why having lower estrogen levels puts a woman at risk for developing osteoporosis. Lyra Ruth Clemente-Chua, M.D., an obstetrician-gynecologist and fellow of the Philippine Obstetrical and Gynecological Society, warns: “Osteoporosis per se is more common than breast, endometrial and cervical cancer. Even if you combine the number of cases of these types of cancer, there are still more cases of women with osteoporosis.”
Deficiency and depletion
At different times in a woman’s life, her estrogen levels may become deficient or depleted.
Depletion occurs as a woman enters menopause. Dr. Clemente-Chua explains, “Estrogen is produced by the follicles in the ovary. All women are born with a limited number of follicles. With age, the follicles undergo cell death.” Fewer follicles mean less estrogen.
Chemotherapy and other cell-destroying treatments can also cause estrogen depletion. For obvious reasons, an ovariectomy, or the surgical removal of ovaries, will mean estrogen can no longer be produced.
Deficiency, on the other hand, may happen even while a woman is still of reproductive age. “Estrogen production may [suffer] when a woman is under a lot of stress,” says Dr. Clemente-Chua. “If there is stress, something happens in the hypothalamic-pituitarian-ovarian axis that suppresses the hormonal mechanism.”
Aside from stress, other factors that may negatively affect estrogen production are over-exercising, sudden weight changes, smoking, malnutrition and infections. Left untreated, estrogen deficiency and depletion may lead to osteopenia, or low bone mineral density, and eventually to osteoporosis.
Even though estrogen depletion inevitably comes with age, it shouldn’t necessarily lead to osteoporosis.