Osteoporosis is a condition characterized by the loss of bone mass or density of the bone accompanied by deterioration of the bone structure which weakens bone strength, thus causing increasing risks for bone fracture.


Normally, bone density increases during childhood and reaches a peak by age 30. Bone density is then maintained for a period of time. After age 35-40, bone density gradually decreases. The mechanism of the loss of bone density is not clearly understood. However, it is believed that this mechanism is associated with the deterioration of a ‘bone mass control’ system in the body. Both men and women will normally lose 1.5-1% of their bone density per years. Some conditions increase this rate of bone loss in women, one of which is Menopause. After Menopause, the level of estrogen – an important hormone that maintains bone density in women – will drop down resulting in accelerated bone loss in some women suffer a loss of bone density by up to 4-6% per year but this varies for each woman.


Bone loss does occur for everyone with different rates of loss. The progression of the condition from the onset of bone loss until osteoporosis develops also varies from person to person. For some people, it may take 10 years to develop osteoporosis but for others, 15-20 years. Nevertheless, there is a greater chance of developing osteoporosis amongst the elderly.



Numerous studies have been conducted to determine the factor that increase the likelihood of developing osteoporosis. These “risk factors” are :

  • Age : both elderly men and women may develop osteoporosis, but the risk is higher for women.
  • Menopause : bone loss increase after menopause because estrogen levels drop sharply.
  • Women who have had both ovaries removed or if their ovaries stopped functioning prematurely for any reason.
  • Thin people with small-body frames and low body weight compared to height.
  • Family history of osteoporosis or incident of bone fracture that may be caused by osteoporosis.
  • Excessive alcohol consumption and heavy cigarette smoking.
  • Long term use of certain medications such as oral corticosteroids, certain anti-seizure medications, thyroxin etc.
  • Some diseases and conditions such as rheumatoid arthritis, hyperthyroidism, disorders associated with the endocrine system etc.


Bone formation and deterioration

The body has osteoclasts (cells that break down bone) and osteoblast (cell that from bones). When a person is suffering from Osteoporosis the activity of osteoclasts is higher than osteoblast and there is an increased loss of bone density.


Normally bone formation and reabsorption for different age ranges.


Diagnosis of osteoporosis

  • Routine X-rays

cannot detect osteoporosis in its early stage but can reveal osteoporosis when more than 30% of the bone

  • Ultrasound
    – used for initial screening only, as moderately precise
    – simple and affordable
    – performed on heels or wrists
  • DEXA (Dual Energy X-ray Absorptiometry)
    – recommended if osteoporosis is suspected or patient has high risk factors
    – standard and accurate diagnosis of osteoporosis
    – high precision and takes only a few minutes to perform the test
    – can be performed on various parts of the body such as spine, hip and wrist


Osteoporosis may be present for decades before becoming evident but it may appear with the following symptoms:

  • a forward bending of the neck
  • loss of height
  • hunched – back
  • upset stomach
  • stress, lack of self confidence
  • susceptibility to bone fracture


Why is osteoporosis a silent danger ?

The progression of osteoporosis is very slow and doesn’t cause any symptoms while losing bone density up to the point of developing symptomatic osteoporosis (fractures). Sometime signs of osteoporosis are a loss in height of more than 1 centimeter per year, muscle atrophy, curvature of the spine alternating with chronic lower back pains. Some patients with require an operation which may not completely repair the hip, resulting in permanent disability.


Prevention and treatment of osteoporosis

  • maintaining a balanced diet
  • eating calcium-rich foods
  • regular exercise
  • try to avoid factors that increase risks of osteoporosis
  • try to prevent falls in the elderly thus preventing bone fracture
  • if many risk factor are present, an early consultation with your doctor is recommended to decrease the risk of bone fractures in the future
  • taking anti-osteoporotic agents as recommended by doctors


Osreoporosis Risk Questionnaire for over 45 years of age

Please enter a check in the column that corresponds to your answer.


If you answer “Yes” for one or more of these questions, you should consult your doctor for evaluation of your risks for osteoporosis.


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