Osteoporosis isn't called the silent thief for nothing. Unfortunately, unless you or your doctor have any reason to suspect that your bones may be thinning, there's no way of telling that it's happening until the damage has been done. People with osteoporosis are more likely to get fractures and these can cause pain, making moving around difficult and affecting your quality of life.
By keeping an eye on certain risk factors, however, doctors can identify and monitor people who have a high risk of having a fracture or osteoporosis. Certain tests can be done to see if there is bone loss happening in people who are at risk. For example, if you are taking high doses of corticosteroids, your doctor may suggest that you undergo bone mineral density (BMD) testing to check out the strength of your bones before something happens. A "baseline" test, one that's done before bone loss is suspected for comparison with later tests, makes it easier for your doctor to monitor your bone health.
The tests for osteoporosis are painless and non-invasive. Dual energy X-ray absorptiometry, or DXA, is the most common because it can measure both the hip and spine density, the areas where osteoporosis-related fractures are most frequent.
As you lie on a table, a machine scans you and calculates how much of the X-ray beam passes through you. This translates into a picture that tells your doctor how thick or thin your bones are. Although the thought of having an X-ray beam going through your body might seem like cause for concern, the amount of radiation is similar to what you might be exposed to on a flight.
Some institutions may do a single photon absorptiometry, or SPA, but this can only tell the density of the bones in the forearm or heel. There are other types of scans as well, but they aren't used as frequently.
If you're told you have osteoporosis or are at risk of having a fracture, your doctor may recommend one or more of the following medications:
- calcium and vitamin D supplements
- bisphosphonates (e.g., alendronate, etidronate, risedronate, or zoledronic acid)
- calcitonin
- denosumab
- romosozumab
- raloxifene
- teriparatide
Which kind of therapy you'll be offered will depend on whether you are a man, a premenopausal woman, or a postmenopausal woman, and the extent of the bone loss. If you are experiencing symptoms of menopause as well as osteoporosis, your doctor may also offer you the treatment option of estrogen therapy, which can treat osteoporosis and menopause symptoms. Be sure to discuss your personal risks and benefits of estrogen therapy with your doctor before making a decision on treatment.
It's important you understand how to take your medications, and that most medications require long-term use – usually several years. If you have any questions, consult your doctor or pharmacist.
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