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Premenopausal osteoporosis

What is premenopausal osteoporosis?

Premenopausal osteoporosis causes weakening of the bones in women before the menopause.

What are the signs of premenopausal osteoporosis?

Premenopausal osteoporosis can be present even though there are no signs or symptoms. How fast someone loses bone depends on her specific risk factors. One woman might be in her 40s or 50s and have very strong bones with no indication of osteoporosis. Another woman can be in her 30s and have early signs of premenopausal osteoporosis, including fractures.

Why do thinner bones lead to painful fractures?

With osteoporosis, your bones eventually become thin enough that they break or fracture from seemingly minor causes. You might, for example, trip over a crack in the pavement and fracture your ankle. Or lifting a bag of compost might cause a wrist fracture.

If the decline in bone continues over a period of 10 to 20 years, bones continue to become weaker, thinner, and easier to break. While the first fracture will usually heal, as long as the bones are thin and weak, they will be susceptible to more fractures. With more fractures, your pain will escalate. Also, deformities in your spine (called a Dowager's hump) and other areas of your body may become more obvious.

You may have more difficulty getting around and doing daily activities because of the pain and stiffness. And more fractures could eventually lead to disability, immobility and even death.

Which women are at risk of premenopausal osteoporosis?

Important risk factors for premenopausal osteoporosis include:

  • A family history of osteoporosis and/or fractures
  • A history of eating disorders such as anorexia or bulimia
  • A history of other diseases, including kidney disease, coeliac disease, thyroid disease, and connective tissue disorders
  • A temporary loss of monthly periods for more than 6 months (except during pregnancy)
  • Long-term lack of exercise or overtraining leading to loss of periods
  • Heavy smoking or drinking
  • Low calcium intake
  • Use of certain drugs, including steroids, anticonvulsants, some cancer chemotherapies and long-term use of the blood thinner heparin.
  • Underweight

While you can control some risk factors, some you can't change. For example, you can't change your family history. Or you may develop cancer and need chemotherapy, even if it does raise your risk of premenopausal osteoporosis.

How can a woman reduce her risk of premenopausal osteoporosis?

All women can take control of their risk of premenopausal osteoporosis. Since there are some risk factors you can't change, you need to focus on what you can change. You can adopt a lifestyle that promotes good bone health if you take the following steps:

  • Eat a diet rich in calcium and vitamin D. Consider using supplements if you can't get enough of these nutrients in food alone.
  • Get regular exercise. You'll need a combination of weight-bearing exercise and resistance training. But watch out for overtraining, which may increase the risk of osteoporosis caused by reduced oestrogen production.
  • Avoid excessive alcohol.
  • Don't smoke.
  • Take osteoporosis medications, if needed.
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