osteoporosis pada wanita

Classification

Primary Osteoporosis

Osteoporosis is often the primary post-menopause women and men in old age with the cause unknown.

Secondary Osteoporosis

While secondary osteoporosis caused by diseases associated with:

* Cushing's disease
Hyperthyroidism *
Hyperparathyroidism *
Hypogonadism *
* Deviation hepar
* Chronic kidney failure
* Lack of movement
* The habit of alcohol drinking
* Pemakai obat-obatan/corticosteroid
* Excess caffeine
* Smoking

Causes

Osteoporosis postmenopausal occur because of lack of estrogen (the main female hormone), which helps set the carriage to calcium in the bones in women. Usually, symptoms arise in women aged between 51-75 years, but could start to appear faster or slower. Not all women have the same risk of suffering from osteoporosis for postmenopausal, white women and eastern regions suffering from the disease more easily than black women.

Osteoporosis senilis is likely a result of calcium deficiency-related imbalance between age and speed of bone destruction and formation of new bone. Senilis means that this situation only occurred in old age. This disease usually occurs at the age of 70 years and over 2 times more likely to attack women. Women often suffer osteoporosis senilis and postmenopausal.

Less than 5% people with osteoporosis also have secondary osteoporosis, caused by other medical condition or by drug-obatan.Penyakit this may be caused by chronic kidney failure, and hormonal aberration (especially tiroid, paratiroid and adrenal) and drugs (eg kortikosteroid, barbiturat, anti-convulsive and excessive hormones tiroid). Excessive use of alcohol and smoking can aggravate this situation.

Osteoporosis juvenil idiopatik is a type of osteoporosis is the cause is not known. This occurs in children and young adults who have a degree and the normal hormone function, vitamin content of normal and does not have a clear cause of rapuhnya bones.
Symptoms

Bone density decreases slowly (especially in people with osteoporosis senilis), so that initially does not cause symptoms of osteoporosis. Some people have no symptoms.

If bone density is reduced so that the bones become kolaps or destroyed, it will be pain relief and bone deformity.

Kolaps spine cause chronic back pain. Spine that can be responsive to kolaps spontaneously or due to mild injury. Usually the pain arises suddenly and is felt in a particular region of the spine, the pain will increase if people stand or walk. If touched, the area will be a pain, but usually this pain will disappear gradually after several weeks or several months. If several vertebrae were destroyed, so will the kelengkungan of abnormal spine (Dowager hump), which cause muscle tension and pain.

Other bones can be broken, which is often caused by pressure or because the light falls. One of the fracture is the most serious pelvic fracture. Which is also often broken arm bone (radius) in the area persambungannya the wrist, called fraktur Colles. In addition, patients on osteoporosis, broken bones tend to be healed slowly.

[edit] Diagnosis

To someone who has broken bones, osteoporosis ditegakkan diagnosis based on symptoms, physical examination and roentgen bone. Further examination may be needed to eliminate other conditions that can be overcome, which can cause osteoporosis.

To diagnose osteoporosis before the occurrence of fracture rate of the examination conducted bone density. Examination is the most accurate DXA (dual-energy x-ray absorptiometry). This secure and does not cause pain, can be done within 5-15 minutes. DXA is very useful for:

* Women who have a high risk of suffering from osteoporosis
* People who diagnosisnya not sure
* Of the results must be treated accurately assessed.

Patogenesis

Mechanisms that underlie osteoporosis in all cases is resorpsi imbalance between bone formation and bone. In normal bone, there is matrik constant bone remodeling; up to 10% of the mass bone remodeling may be experiencing at the time point of time. The process of taking place in the unit-unit multiseluler bone (bone multicellular units (BMUs)) was first described by Frost 1963. [1] dislocated diresorpsi by osteoklas cells (derived from the bone marrow), after disetorkan by new bone cells osteoblas. [ 2]

Medicine

Goal is to improve the treatment of bone. All women, especially those suffering from osteoporosis, it should consume calcium and vitamin D in adequate amounts.

Post-menopause women with osteoporosis can also get estrogen (usually together with progesteron) or alendronat, which can slow or stop the disease. Bifosfonat also used to treat osteoporosis.

Alendronat work:

* Reduce the speed of absorption of bone in women after the menopause
* Meningkatakan bone mass in the spine and pelvis
* Reduce the number incident fracture.

To be absorbed properly, alendronat must be drunk with a full glass of water in the morning and within 30 minutes after it should not be eating or drinking the other. Alendronat layer can mengiritasi the top of the alimentary tract, so that after meminumnya can not lie, at least 30 minutes afterwards. This medicine should not be given to people who have difficulty swallow or esophagus and stomach disease specific.


Kalsitonin recommended to be given to those who suffered broken bones, along with a sore back. This drug can be given in the form of injection or nose spray.

Additional fluorida can increase bone density. But the bones can become brittle and deviation, so that pemakaiannya not recommended.

Men who suffer osteoporosis usually get extra calcium and vitamin D, especially if the examination results show that the body does not absorb calcium in sufficient amounts. If testosteronnya low degree, can be given testosteron.

Fracture because of osteoporosis should be treated. Broken pelvis usually be corrected with surgery action. Fracture usually digips circle or repaired with surgery. Kolaps on the spine with back pain that great, given sedative, installed supportive back brace and physical therapy is done.

Prevention

Prevention osteoporosi include:

* Maintain or increase bone density by consuming adequate calcium
* To exercise the burden
* Consume drugs (for some people).

Consume the amount of calcium in a relatively very effective, especially before achieving maximum bone density (about age 30 years). Drink 2 glasses of milk and the additional vitamin D each day, can increase bone density in the half-old woman who previously did not get enough calcium. We recommend that all women take calcium tablets every day, the recommended daily dose is 1.5 grams of calcium.

Exercise load (such as walking and climbing stairs) would increase bone density. Swimming does not increase bone density.

Estrogen helps maintain bone of the women and often drunk together with progesteron. Sulih estrogen therapy is effective starting in the 4-6 years after menopause, but if the new starting more than 6 years after menopause, can still be slow bone fragility and reduce the risk of fracture. Raloksifen medicine is a new estrogen-like, which may be less effective than estrogen in preventing bone fragility, but does not have an effect on the breast or uterus. To prevent osteroporosis, bisfosfonat (eg alendronat), can be used alone or together with hormone therapy sulih.

Epidemiology

While this is 1 of 3 women and 1 of 12 men over the age of 50 years in the world carry osteoporosis. Add this event fraktur millions of other pertahunnya that involve most of the lumbar vertebra, pelvis and wrist (wrist). Fragility fracture of the rib is also common in men.

Fraktur pelvis

Fraktur pelvis most often occur due to osteoporosis. In the U.S., more than 250,000 fraktur pelvic pertahunnya is a result of osteoporosis. [3] It is estimated that a white female age 50 years have a 17.5% life time risk of fraktur femur proksimal. Fraktur pelvic incidence increased each decade from the sequence to a sequence of 6 to 9 for both women and men in all populations. Top incidence found in the men and women aged 80 years and over. [4]

Fraktur Vertebral

Between 35-50% of all women above age 50 years at least one vertebral contract fraktur. In the U.S., 700,000 fraktur vertebra occurred pertahun, but only about 1 / 3 is known. Sequence of events in 9704 women aged 68.8 years on the study for 15 years, 324 women have been found suffering fraktur vertebral start at the time included in the study, 18.2% developed into fraktur vertebra, but the risk increased to 41.4% in women who have previously occurred fraktur vertebra. [5]

Fraktur wrist

In the U.S., 250,000 wrist fraktur each year is a result of osteoporosis. [3] Fraktur wrist fraktur third type is the most common of osteoporosis. Risk of life ditopang time fraktur Colles about 16% for white women. When women reach the age of 70 years, about 20% of at least one fraktur wrist [4]

Fraktur rib

Fragility fracture of the rib bones generally occur in men age 25 years young and over. Signs of osteoporosis in men is often ignored because it is often physically active and fraktur suffering at the time of physical activity practice. For example when falling or when Berski water jet ski. However, rapid tests of individuals following testosteron level fraktur diagnosis will be easily visible if the possibility of individual risk.