The osteopenia is a decreased bone density but it is not to the extent of osteoporosis [1]. When there is decreased bone density, then it can lead to bone fragility and an increased chance of breaking a bone (fracture). Women who are over age of 65 and any other postmenopausal woman should be tested for osteopenia or osteoporosis because they have increased risk of getting these conditions. It is known that the DXA scan is widely available and accurate method for diagnosis osteoporosis or osteopenia. Not every single person who suffers from osteopenia needs treatment with prescription medications. Your doctor can tell you if you should use prescription medications based on your bone density and other risk factors. There are many simple ways which can help you to prevent osteopenia, such as getting plenty of exercise, not smoking, avoiding excessive alcohol and an adequate intake of Vitamin D and calcium. Women are mostly affected by osteopenia [2] but also men can be affected by osteopenia and osteoporosis so they need to be evaluated for these bone conditions when they are considered to have a risk of them. It is important to know that even osteoarthirits, osteomyelitis and osteomalacia sound similar they are not the same. They are three different conditions which are frequently confused with osteopenia because they sound similar.
Osteopenia Symptoms and Causes
Symptoms: This condition is not causing pain unless a bone is fractured (broken). The fractures which are happening in people with osteopenia are not always causing a pain. Osteoporosis or osteopenia can be present for many years prior to diagnosis for many different reasons. There are many bone fractures which are caused by osteoporosis or osteopenia, such as vertebral fracture (which is a fracture of a bone in the spine) or a hip fracture which are very painful. But there are many cases when some fractures, especially vertebral fractures (which are fractures of the bony building blocks of the spine) which can be painless and this is a reason why the osteoporosis or osteopenia can go undiagnosed for many years. But there is not just pain. In addition to it, there can be loss of height and recurrent spinal (vertebrae) fractures which can cause stooped posture (dowager’s hump).
Causes: Our bodies are constantly remodeling our bones and they naturally become thinner as we are getting older because starting in the middle age, the existing bone is reabsorbed by the body more quickly than new bone in the body is made. This is causing our bones to lose minerals, structure and heaviness (mass) which is leading to weaker and more prone to breaking and this is leading to osteopenia. We know that all people begin to lose some bone mass after they reach peak BMD at about thirty years of age. The thicker your bones are by the about age of thirty, then longer it takes to develop osteoporosis or osteopenia. There are some people who have osteopenia and who may not have had significant bone loss and these people naturally can have a lower bone density [3]. Also there are some cases when osteopenia can be a result of other medical conditions, medications or medical processes. It is known fact that women are having more chances to get osteopenia and osteoporosis than men [2]. We know that women have a lower peak BMD and the loss of bone mass speeds up the hormonal changes take place during the menopause. There are some factors which can contribute to osteopenia in both men and women, such as exposure to radiation; chemotherapy or medications, such as steroids used to treat a variety of conditions, including asthma; eating disorders or metabolism problems that do not allow the body to take in and use enough vitamins and minerals.
Osteopenia Risk factors
Risk factors: There can be different causes for osteopenia but some factors can increase your risk of getting this condition, such as
- Drinking excessive amounts of alcohol [4]
- Regular consumption of sodas
- Smoking [5]
- Medications (these medications are including prednisone and corticosteroids) and antiseizure medications
- Malabsorption due to conditions (such as celiac sprue)
- Lack of adequate physical activity [3]
- Immobility
- Being Asian or Caucasian [6]
- Being thin
- Chronic inflammation due to medical conditions (such as rheumatoid arthritis)
- Having a family history of osteoporosis
- Hormonal causes, including decreased estrogen (such as in women after menopause) or testosterone [7]
References:
[1] Contreras-Bolivar V, Olveira G, Porras N, et al. Osteopenia and osteoporosis in patients with bronchiectasis: Association with respiratory parameters, body composition, muscle strength and bone remodeling biomarkers. Scientific Reports. 2019;9.
[2] Alswat KA. Gender disparities in osteoporosis. Journal of Clinical Medicine Research. 2017;9(5):382–7.
[3] Benedetti MG, Furlini G, Zati A, Mauro GL. The effectiveness of physical exercise on bone density in osteoporotic patients. BioMed Research International. 2018;2018:4840531.
[4] Wayne Sampson H. Alcohol and other factors affecting osteoporosis risk in women. 2003. Retrieved from pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm
[5] Al-Bashaireh AM, Haddad LG, Weaver M, et al. The effect of tobacco smoking on bone mass: An overview of pathophysiologic mechanisms. Journal of Osteoporosis. 2018;2018:1206235.
[6] Chen P, Li Z, Hu Y. Prevalence of osteoporosis in China: a meta-analysis and systematic review. BMC Public Health. 2016;16:1039.
[7] Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Przeglad Menopauzalny. 2014;13(4):213–20.
