[Health in the 100-Year Life Era] Osteoporosis That Comes Without Painful Symptoms

Decreased Estrogen Hormone Levels
A Common Condition in Postmenopausal Women
Not Related to Joint Pain Treatment

Professor Son Gi-yeong, Department of Family Medicine, Asan Medical Center, Seoul.

When I was young, we used to sing a song called "Kkoburang Halmeoni" (Crooked Grandma). Grandmothers whose spines curved forward were called that because their vertebrae had been compressed and fractured. Normally, vertebrae are close to a rectangular shape, but when compressed and fractured, they become distorted into a shape closer to a triangle, and as these stack up, the spine takes on that appearance.

Why did grandmothers in the past experience such compression fractures of the vertebrae? The reason is osteoporosis.

In osteoporosis, "gol" means bone, "da" means many, and "gong" means holes. Literally interpreted, it is a disease where many holes form in the bones. This is almost a direct translation of the English term for the same disease. In reality, osteoporosis refers to a condition where the bone content inside the bones decreases. When the bone content decreases, the bones become weak and prone to fractures. When bones break, it is painful and requires treatment, which can be difficult, but if the thigh bone (femur) breaks, it can become a very serious situation because the person may no longer be able to stand or walk. Therefore, preventing bone fractures, that is, fractures, is the main goal of osteoporosis treatment.

Osteoporosis is a common disease among women after menopause. Normally, bones weaken with age regardless of gender after the 30s, but osteoporosis is common in women after menopause due to its relation to female hormones. Before menopause, women produce and maintain sufficient amounts of a female hormone called estrogen, but around menopause, the production of this hormone gradually decreases, leading to a reduction in hormone levels in the body. The problem is that this hormone has played a role in maintaining adequate bone mass. So, when menopause arrives and estrogen decreases, bones that are already weakening with age become even more fragile. However, it is not recommended to take female hormones solely for the prevention or treatment of osteoporosis during menopause.

Osteoporosis basically has no symptoms. Therefore, osteoporosis is mostly discovered through screening. Osteoporosis is usually confirmed by taking X-rays of the lower back vertebrae (lumbar spine) and thigh bones, a test called bone density testing. Many people often say that after hearing they have osteoporosis in the thigh bone, their knees start to hurt. However, knee pain is usually due to joint pain where bones meet, while osteoporosis is a weakening of the bone itself and does not cause pain before fractures occur. Similarly, some patients complain that their joint pain remains even while receiving osteoporosis treatment, but osteoporosis treatment does not relieve joint pain. Osteoporosis treatment is not aimed at reducing joint pain but at preventing bone fractures.

If bones become weak beyond a certain level, osteoporosis medication should be used, but even in cases of osteopenia, which is a precursor to osteoporosis, calcium intake and weight-bearing exercise are recommended for management. Some people ask about calcium supplements after hearing that taking them might increase cardiovascular disease risk. Many studies have been conducted on this, and the overall conclusion is that calcium supplements neither significantly benefit nor harm cardiovascular health. Therefore, if your primary care physician advises you to take calcium supplements for bone health, it is recommended to follow that advice. However, taking calcium supplements for osteoporosis prevention without any bone density abnormalities is not recommended. There is no evidence that taking calcium supplements as a nutritional supplement in advance is helpful.

Songi-yeong, Professor of Family Medicine, Seoul Asan Medical Center

This content was produced with the assistance of AI translation services.