Young women and pregnancy
Young women who have risk factors for osteoporosis and fractures need to carefully consider their medication options if they are planning a pregnancy. None of the drugs for managing osteoporosis has enough safety data available to recommend using them in women who are pregnant or breastfeeding.
Bisphosphonates, even after you stop taking them, can stay in your body a long time. Animal studies show that bisphosphonates cross the mother’s placenta and enter the fetus. The risk of harm to the fetus in humans is not known. Thus, women who want to become pregnant later should weigh the expected benefits of bisphosphonates against the possible risks. If a woman who has taken a bisphosphonate becomes pregnant, she should have her blood calcium levels checked, because they could become low.
Prevention
Lifestyle changes may be the best way of preventing osteoporosis. Here are some tips:
Make sure you get enough calcium in your diet or through supplements (roughly 1,000–1,200 mg/day, but will depend on your age).
Get enough vitamin D (400–1,000 IU/day, depending on your age and your blood level of vitamin D measured by your doctor).
Stop smoking.
Avoid excess alcohol intake: no more than two or three drinks a day.
Engage in weight-bearing exercise. Aim for at least 2½ hours a week (30 minutes a day five times a week or 50 minutes a day three times a week), or as much as you can. Exercises that can improve balance, such as Tai Chi or yoga, may help prevent falls.
You also should get treatment of any underlying medical problem that can cause osteoporosis. If you are on a medication that can cause osteoporosis, ask your doctor if you can lower the dose or take another type of medicine. Never change the dose or stop taking any medicine without speaking to your doctor first.
If you have low bone density and a high risk of breaking a bone, your doctor may suggest medicine to prevent your bones from getting weaker. (See the section “How is glucocorticoid-osteoporosis treated?”) Health care providers now have a tool for estimating the risk of a patient’s having an osteoporotic fracture in the next 10 years. This fracture risk assessment tool, from the World Health Organization, is called FRAX. The score can help guide treatment decisions.
What is the broader health impact of osteoporosis?
The most serious health consequence of osteoporosis is a fracture. Spine and hip fractures especially may lead to chronic pain, long-term disability and even death. The main goal of treating osteoporosis is to prevent fractures.
Living with osteoporosis
If you have osteoporosis, it is important to help prevent not just further bone loss but also a fracture. Here are some ways to decrease your chance of falls:
Use a walking aid. If you are unsteady, use a cane or walker.
Remove hazards in the home. Remove throw rugs. Also, remove or secure loose wires or cables that may make you trip. Add nightlights in the hallways leading to the bathroom. Install grab bars in the bathroom and nonskid mats near sinks and the tub.
Get help carrying or lifting heavy items. If you are not careful, you could fall, or even suffer a spine fracture without falling.
Wear sturdy shoes. This is above all true in winter or when it rains.
Points to remember
Make sure there is enough calcium and vitamin D in your diet.
Be physically active and do weight-bearing exercises, like walking, most days each week.
Change lifestyle choices that raise your risk of osteoporosis.
Implement strategies to help decrease your risk of falling.
The rheumatologist's role in the treatment of osteoporosis
As doctors who are experts in diagnosing and treating diseases of the joints, muscles and bones, rheumatologists can help find the cause of osteoporosis. They can provide and monitor the best treatments for this condition.
Young women and pregnancy Young women who have risk factors for osteoporosis and fractures need to carefully consider their medication options if they are planning a pregnancy. None of the drugs for managing osteoporosis has enough safety data available to recommend using them in women who are pregnant or breastfeeding. Bisphosphonates, even after you stop taking them, can stay in your body a long time. Animal studies show that bisphosphonates cross the mother’s placenta and enter the fetus. The risk of harm to the fetus in humans is not known. Thus, women who want to become pregnant later should weigh the expected benefits of bisphosphonates against the possible risks. If a woman who has taken a bisphosphonate becomes pregnant, she should have her blood calcium levels checked, because they could become low. Prevention Lifestyle changes may be the best way of preventing osteoporosis. Here are some tips: Make sure you get enough calcium in your diet or through supplements (roughly 1,000–1,200 mg/day, but will depend on your age). Get enough vitamin D (400–1,000 IU/day, depending on your age and your blood level of vitamin D measured by your doctor). Stop smoking. Avoid excess alcohol intake: no more than two or three drinks a day. Engage in weight-bearing exercise. Aim for at least 2½ hours a week (30 minutes a day five times a week or 50 minutes a day three times a week), or as much as you can. Exercises that can improve balance, such as Tai Chi or yoga, may help prevent falls. You also should get treatment of any underlying medical problem that can cause osteoporosis. If you are on a medication that can cause osteoporosis, ask your doctor if you can lower the dose or take another type of medicine. Never change the dose or stop taking any medicine without speaking to your doctor first. If you have low bone density and a high risk of breaking a bone, your doctor may suggest medicine to prevent your bones from getting weaker. (See the section “How is glucocorticoid-osteoporosis treated?”) Health care providers now have a tool for estimating the risk of a patient’s having an osteoporotic fracture in the next 10 years. This fracture risk assessment tool, from the World Health Organization, is called FRAX. The score can help guide treatment decisions. What is the broader health impact of osteoporosis? The most serious health consequence of osteoporosis is a fracture. Spine and hip fractures especially may lead to chronic pain, long-term disability and even death. The main goal of treating osteoporosis is to prevent fractures. Living with osteoporosis If you have osteoporosis, it is important to help prevent not just further bone loss but also a fracture. Here are some ways to decrease your chance of falls: Use a walking aid. If you are unsteady, use a cane or walker. Remove hazards in the home. Remove throw rugs. Also, remove or secure loose wires or cables that may make you trip. Add nightlights in the hallways leading to the bathroom. Install grab bars in the bathroom and nonskid mats near sinks and the tub. Get help carrying or lifting heavy items. If you are not careful, you could fall, or even suffer a spine fracture without falling. Wear sturdy shoes. This is above all true in winter or when it rains. Points to remember Make sure there is enough calcium and vitamin D in your diet. Be physically active and do weight-bearing exercises, like walking, most days each week. Change lifestyle choices that raise your risk of osteoporosis. Implement strategies to help decrease your risk of falling. The rheumatologist's role in the treatment of osteoporosis As doctors who are experts in diagnosing and treating diseases of the joints, muscles and bones, rheumatologists can help find the cause of osteoporosis. They can provide and monitor the best treatments for this condition.
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