What is Osteoporosis?

By Orthopedic Surgeon Dr. James Slauterbeck

When we think of osteoporosis, we usually picture older adults, like grandparents, who walk slowly, have back pain, or have trouble standing up straight. We may hear about someone older falling and breaking a hip or wrist and think, “That’s just part of getting old.” But osteoporosis can begin much earlier in life, even in childhood or the teen years.

Osteoporosis is a disease that makes bones thin, weak, and more likely to break. People often don’t feel anything until one day a simple fall causes a serious injury. Developing osteoporosis is a silent process that usually isn’t recognized until after a fall. Although it is more common in women, men can develop it too.

Bones grow the most during childhood and the teen years, which makes that time the best opportunity to build strength and density. To do this, the body needs enough calcium, vitamin D3, hormones (like estrogen), and regular exercise, especially weight training. If people don’t get enough of these while young, their bones may not be strong enough later in life.

Girls and young women are especially at risk for osteoporosis. Most of the calcium in their bones is stored between the ages of 12 and 30. Later in life, especially during pregnancy or after menopause, women naturally lose bone mass. If they didn’t build strong bones earlier, they are more likely to develop osteoporosis. Females who have disordered eating habits, avoid weight training, or develop irregular menstrual periods, may not produce enough hormones to support bone health. It is important to talk to a doctor if periods are irregular or absent.

Even though osteoporosis is more common in women, men can also develop weak bones. Low testosterone levels, a lack of weight-bearing exercise, excessive alcohol intake, and smoking are all risk factors for osteoporosis in men.

To keep bones healthy and strong, it’s important to eat foods rich in calcium. These include milk, cheese, yogurt, green leafy vegetables, and canned fish with bones, like sardines. The body also needs vitamin D3 to absorb calcium. People can get vitamin D3 from sunlight, from certain foods like fortified milk, or through supplements.

Exercise plays a major role in keeping bones strong. Strength training, such as push-ups, squats, or lifting weights, helps bones grow stronger. Running and biking are excellent for heart and overall health, but doing only aerobic activities without any strength training can weaken bones over time.

Hormones are also essential for bone health. In females, estrogen is a key hormone that protects bone density. When estrogen levels drop, such as during menopause or when periods stop, bones can weaken. Some women may benefit from hormone treatment in addition to calcium and vitamin D3 supplements. Females, with irregular menstrual periods or who have less than 11 menstrual periods per year, should consult a doctor to discuss how this might affect their bones.

Doctors can treat osteoporosis, but it is much easier to prevent it from developing in the first place. The best time to build strong bones is while a person is still young. Unfortunately, many children and teens do not get enough calcium, vitamin D3, or exercise. Talking to a doctor can help make sure your body is getting what it needs to stay healthy.

Osteoporosis may not appear until someone is older, but it often begins during youth. Eating nutritious foods, getting enough calcium and vitamin D3, staying active with strength training, and maintaining overall health are all essential steps. Avoiding excessive alcohol and quitting tobacco use can also help preserve bone mass. Taking care of your bones now can help you stay strong, independent, and healthy later in life.

James Slauterbeck, MD, is an orthopedic surgeon whose special interests include sports medicine, adolescent sports medicine, female sports medicine, and high school and college athletic injuries. He is affiliated with UNC Health Orthopedics at Southeastern Health Park and UNC Health Southeastern. To learn more, call (910) 738-1065 or visit https://www.unchealth.org/care-services/doctors/s/james-r-slauterbeck-md.