Osteoporosis is the depletion of bone mass causing the bones to become prone to fractures. In other words, osteoporosis is a bone disease that occurs when your body loses too much bone, makes too little bone, or both. If you have osteoporosis, you are most likely not to show any symptoms in the early stages of bone loss but you may develop back pain (due to a fracture or a collapse of the vertebra) and loss of height over a period of time.

The incidence of osteoporosis is on the rise and it has become very common in the past decade due to a sedentary lifestyle and lack of regular exercise. This condition is more prevalent in women and studies show that 70% of all osteoporosis cases are of women. 

Every 1 in 2 women, who is  50 years or older, is likely to have osteoporosis, while the ratio is half in men. In this article, we will look at the major causes contributing to osteoporosis in women and understand why it is more common in women than in men.

Causes of Osteoporosis in Women

Bone density or bone mineral density (BMD) or bone mass is the amount of bone mineral, namely calcium and phosphorus that your bone tissues contain. Calcium and phosphorus are minerals necessary for the growth and maintenance of your bones, which are obtained mainly through your diet. Adult diet typically contains abundant phosphorus but it is seen that around 10% - 15% of elderly women have less than 70% of the recommended intake of phosphorus.

Reduced bone mineral density is the foremost cause of osteoporosis and is more common in women due to the following reasons:

1. Estrogen. Estrogen, the primary female sex hormone is produced in your ovaries. Ovaries are the main pair of organs of your reproductive system, responsible for secreting hormones and releasing eggs for fertilization to prepare for pregnancy.

Estrogen is primarily responsible for regulating your menstrual cycles (monthly shedding of your uterine tissues in the form of blood) and has an impact on your overall health. It is also responsible for maintaining bone health as it metabolizes calcium. By the time you reach menopause (natural cessation of your menstrual cycle which happens between 45 and 55 years of age), production of estrogen is diminished, which in turn, reduces bone density.

Therefore, women tend to lose bone mass at a faster rate after 50 years of age. Reduced estrogen is also possible in women who get their ovaries removed and are at risk of developing osteoporosis at a younger age than men.

2. Faster aging. Aging process is naturally faster in women than in men. Menopause is one of the causes of faster aging in females but it is not the only reason. Another reason is muscle mass. Muscle mass is the amount of muscle in your body, including skeletal muscles, smooth muscles, and cardiac muscles. It can be measured as part of your total body composition, along with fat mass (the actual weight of fat in your body) and bone mass.

Your muscles produce stress on your bones and help in calcium deposition in your bones. When an injury or stress occurs, calcium travels through your bloodstream to the injured area to help repair damage.

Males have more muscle than females and muscle atrophy (loss of muscle tissue) due to aging is slower in males. Females tend to lose muscles faster and calcium deposition due to muscle stress is not very efficient in females. Hence, as a result, a reduction in bone density is higher and faster in females due to faster aging, resulting in osteoporosis.

3. Genetics. Women have genetically (heredity) thinner bones than men. Men and women of the same age group with comparable height and weight, if studied for bone mass, men will have more bone density than females. Before puberty, bone mass in both male and females grow at the same rate but after puberty, males tend to have higher growth in bone mass than females.

Puberty is the time in life when a boy or girl becomes sexually mature. It is a process that usually happens between ages 10 and 14 for girls and ages 12 and 16 for boys, where they undergo various physical changes.

4. Under-diagnosed in men. Osteoporosis is more suspected in females than in males. This is the reason why men often go undiagnosed of osteoporosis and therefore, there are less reported cases of osteoporosis in men. Osteoporosis is usually asymptomatic and is often diagnosed after a fragility fracture.

Given the probability of osteoporosis recorded in women, it is recommended that every woman above the age of 45-50 years must go for regular bone check-ups and bone densitometry tests (an x-ray test that accurately measures your bone density). If detected early, the treatment can be much more effective than at a later stage.

Talk to your gynaecologist/general physician/orthopaedician to know more about osteoporosis, its diagnosis, and treatment. Certain measures that you can take to prevent osteoporosis include- exercising regularly, eating a bone-healthy diet which includes calcium-rich foods like milk and milk products, soya drinks, green leafy vegetables, dried peas, beans, and fish, and checking your bone health regularly. 

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