Overview
Osteoporosis is a condition of low bone mass, or when the quality or structure of the bone changes, resulting in weak and brittle bones. Bone affected by osteoporosis is more fragile and is more likely to fracture spontaneously or with minor trauma such as with minor falls (from standing height or less, which would not normally break healthy bone), or normal stresses such as bending, lifting or even coughing. Osteoporosis-related fractures often occur in the hip, spine or wrist.
Why is osteoporosis important?
Preventing fractures is important because fractures are not only painful, but importantly, they can lead to other medical problems that take away your mobility and independence.
Causes
Who is at risk of having osteoporosis?
Osteoporosis is common in Singapore, and the risk increases with age. Women after the age of menopause are more likely to develop osteoporosis. A number of other risk factors are also associated with developing osteoporosis, such as
- Smoking
- Heavy alcohol intake
- Insufficient sunlight exposure or vitamin D
- Poor mobility and sedentary lifestyle
- Malnutrition and anorexia
- Family history
- Certain medical conditions, such as overactive thyroid, parathyroid or adrenal glands, chronic inflammation, early menopause, etc.
- Certain medications, such as hormone treatment for breast or prostate cancer, anti-epilepsy drugs, proton pump inhibitors, steroids, etc.
Osteoporosis is usually a "silent" disease which causes no symptoms or pain, until the weakened bones result in a painful fracture. Sometimes, osteoporosis is incidentally discovered on bone mineral density scan.
Detection & Treatment
What is the treatment for osteoporosis?
Treatment for osteoporosis may include exercise, calcium and vitamin D replacement, and medications. Interventions aimed at fall prevention, weight-bearing and resistance exercises are all important, as well as maintaining other aspects of a healthy lifestyle such as smoking cessation and drinking less alcohol.
Vitamin D helps your body absorb the calcium in your diet. Apart from taking supplements and foods rich in calcium and vitamin D, your skin can also make vitamin D when exposed to sunlight.
Foods rich in calcium include:
- Dairy products such as milk, yoghurt, cheese
- Green leafy vegetables such as kale, okra, chye sim, broccoli, kailan
- Soy products e.g. Soya drinks with added calcium, tau kwa, silken tofu
- Enriched bread
- Fish where you eat the bones such as sardines and ikan billis
Foods rich in vitamin D include:
- Oily fish such as salmon, tuna, cod fish, sardines and mackerel
- Egg yolks
Your doctor will discuss the best options of medications to be prescribed for you. Some examples of common medications prescribed include:
- Bisphosphonates: These drugs work by slowing down bone loss, which can reduce the risk of fractures.
- Selective estrogen receptor modulator (SERM): They have estrogen-like effects and can be used in post-menopausal women to improve bone density in the spine.
- Hormone replacement therapy: Oestrogen and testosterone replacement can be given in certain groups of women and men who are deficient in these hormones respectively.
- RANK ligand inhibitor: This drug is an injection into the skin, which slows down bone loss and reduces fracture risk.
- Parathyroid hormone analogues: They are injections used for a short duration of time which have good effectiveness in building bone.
Care Management
Healthcare providers who treat osteoporosis include:
- Primary care physicians, e.g. General Practitioners and Polyclinic doctors
- Endocrinologists
- Geriatricians
- Rheumatologists
- Orthopaedic doctors
- Gynaecologists
Specialties & Services
