Northwestern Medicine launches program to help women understand risk factors for osteoporosis

Loss of bone density is common as women age, particularly around menopause when women lose more bone than they make. When bone density becomes so low that fracture is likely, the condition is called osteoporosis. Eight million women in the United States have osteoporosis, but another 34 million are living with low bone mass (osteopenia) unaware they are at risk for fracture. Northwestern Medicine Center for Menopause recently launched its Program for Women's Bone Health to help women understand their risk factors for osteoporosis and to optimize bone heath and lower the risk of fracture through comprehensive screening and treatment plans.

Osteoporosis is a silent disease; most women don't know they have it until a fracture occurs. Fractures can be life-altering and even life-threatening. As we age, it is critical that women get bone density screenings and take steps to prevent bone loss and fractures."

Kristi Tough DeSapari, MD, director of the Northwestern Medicine Program for Women's BoneHealth

Two million fractures are attributed to osteoporosis every year. Fractures can be devastating to women, particularly older women; 25 percent of women older than age 50 who have an osteoporotic hip fracture ultimately die as a result of the injury. Other fractures, such as spine fractures, cause pain, breathing difficulty and loss of height.

Women in menopause are at heightened risk for osteoporosis and fracture. Women lose estrogen as a natural result of menopause, which is connected to decrease in bone density.

"The repercussions of estrogen deprivation are lifelong and with increasing life expectancy, women today can expect to live almost 40 percent of their lives after the menopause transition," said Lauren Streicher, MD, director of the Northwestern Medicine Center for Menopause. "Strategies to optimize bone health should start prior to menopause and women must understand their risk factors for osteoporosis. Our new Program for Women's Bone Health will help women evaluate their risk factors and develop a plan to minimize bone loss and lower risk for fracture. We're excited to offer this as part of our comprehensive Center for Menopause, where women receive personalized care from expert clinicians to address all their health care associated to the changes they experience from menopause."

In addition to offering care for those already diagnosed with osteoporosis, Northwestern Medicine's Program for Women's Bone Health will focus on identifying women at high risk for developing osteoporosis through comprehensive screening then provide personalized prevention strategies to limit the risk of fractures.

"Risk factors for osteoporosis can be associated with both genetic and lifestyle factors," said Dr. Tough DeSapari. "Each woman is different and needs to understand her personal risk. Once we understand her risk factors, then we can come up with a screening plan and strategies for prevention and a treatment plan, if needed."

The timing of a women's first screening dual-energy X-ray absorptiometry (DXA), a low-radiation scan of the hips and spines, is dependent on individual risk factors. All women should start screening by age 65, but many with risk factors should start screening in the early postmenopausal years.

Common risk factors for bone loss and fracture include:

• Early menopause (before age 45) or premature ovarian insufficiency (loss of menses before age 40) from natural or surgical causes

• Personal history of fracture from a fall of standing height or less

• Low body weight (BMI less than 20)

• Lifestyle choices, such as alcohol overuse, smoking and a sedentary lifestyle

• Medical conditions, including rheumatoid arthritis, diabetes, vitamin D deficiency and many others

• Certain surgeries including gastric bypass or other GI surgeries

• Medications including steroids, SSRIs, PPIs and many more

Treatment for bone loss may be lifestyle changes, including exercise and dietary changes and use of supplements. Other options may include hormone therapy, oral medications, injectable medications or infusions.

"At our center, we have the most advanced screening on site, so our patients will get results promptly and leave their appointment with a personalized strategy for optimizing their bone health or treating their osteoporosis," said Dr. Tough DeSapari. "We're also uniquely equipped to provide advanced osteoporosis care and support for patients with complex conditions, including premenopausal, post-transplant and glucocorticoid-induced bone loss. With access to specialists across Northwestern Memorial Hospital, we will collaborate with orthopedics, physical therapy and others to address prevention of both new and recurrent fractures for our patients."