Why Women Are More Likely To Suffer Osteoporosis Than Men

A Chinese hunchback woman
Image is courtesy of zhee

Osteoporosis, a silent disease of decreased in bone mass and density, in which the bones become weak, and lead to an increased risk of fracture incident (break bones), especially in the hip, spine, and wrist. Fracture incidents due to osteoporosis, will occur in healthy people, who would not normally break a bone, in both men and women.

According to Nicholas Perricone, M.D.'s book, 7 Secrets to Beauty, Health & Longevity, page 72, there are several unsupported claims, that women are much more likely to suffer from osteoporosis than men. Below I found several studies in Pubmed to explain dr. Perricone's following claims:

Claim: Women have less bone mass than men.

Fact:
True indeed. Compare to women, men is given larger bone size, and greater bone area at all sites. But, according to a study, there is virtually no clinical difference, in bone mineral density (BMD) precision between men and women.

BMD, the amount of mineral per square centimeter of bone, is an important predictor for osteoporosis. The actual BMD, which is usually expressed in grams per milliliter, is measured by X-Ray Absorptiometry, or Tomography. (MeSH)

Recent study by University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA, compared BMD precision, in 180 older men and women, by using a Lunar iDXA densitometer. The study resulted that there is virtually no clinical difference, in BMD precision between men and women. (Krueger D, et al. 2013)

Claim: Women tend to live longer than men.

Fact:
Totally true, but I found no link between extended lifespan with osteoporosis.

According to recent article by The Institute of Healthy Ageing, London, UK, sex differences in lifespan exist worldwide, with women outliving men, by more than a decade in some countries. Although most sexually reproducing species examined had shown sex differences, in patterns of ageing, but a comprehensive explanation does not exist.

The sex steroids, such as androgens and oestrogens, were examined their regulation of biological processes, that can affect ageing and lifespan. The sexes, in which able to respond differently to dietary restriction, and to alter the activity of nutrient sensing pathways, had come up with the conclusion that females was showing a greater capability for extending life. (Regan JC, et al. 2013)

Claim: Women usually consume less calcium than men.

Fact:
The statement is doubtful and unclear.

Healthy diet with a sufficient intake of calcium, and vitamin D will help making the bones strong. People are usually having less than half the calcium, and vitamin D they need. The food sources of calcium include, low fat milk, yogurt, cheese, orange juice, cereals, and breads.

In my previous post, which titled, Dietary Intake of Vitamin D Against Diabetes and Cancer, I had also mentioned two studies, in relating to vitamin D, calcium, and fracture incidence.

A study had resulted that four monthly supplementation, with 100,000 IU oral vitamin D, may prevent fractures without adverse effects in men and women. However, another trial did not support the calcium, and vitamin D supplementation, either alone, or in combination, for the prevention of fractures in elderly people.

Recent study by 1 Institute for Aging Research, Boston, MA, USA, suggested that greater protein intake benefits women especially those with lower calcium intakes. But, protein effects are not significant for short term changes in bone density. In the contrary, in men, higher protein intakes lead to greater bone loss. (Sahni S, et al. 2013)

According to a study by Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan, among 46,465 men, and 64,327 women, aged 40-79 years, who responded to the self administered food frequency questionnaire, men aged 40-49 years had the lowest mean intake levels of calcium, with other vitamins and minerals. While in women aged 70-79 years, had the lowest mean intake levels of calcium, retinol, and vitamins A. (Iso H, et al. 2005) There are not enough studies to support dr. Perricone's claim.

Claim: The rate of bone loss accelerates after menopause, because the female hormone estrogen is needed to keep the bones strong.

Fact:
True indeed. Postmenopausal osteoporosis is a condition associated with low bone mass, resulting from the increased bone resorption, that occurs following a decline in estrogen levels. (Lagari VS, et al. 2013)

Claim: If a woman's ovaries are surgically removed, more rapid bone loss may occur, because estrogen is made in the ovaries.

Fact:
Totally true. Bilateral oophorectomy (ovariectomy, the surgical removal of both ovaries, resulting in surgical menopause) at the time of hysterectomy (a surgical operation to remove all, or part of the uterus) for benign disease, is commonly practiced, in order to prevent the subsequent development of ovarian cancer, or other ovarian pathology, that might require additional surgery.

Estrogen deficiency resulting from pre-menopausal, and post-menopausal oophorectomies, has been associated with higher risks of coronary heart disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression and anxiety, in many studies. Nowadays, observational studies suggest, that bilateral oophorectomy may do more harm than good. In women who are not at high risk of developing ovarian, or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution. (Parker WH, et al. 2009)

Conclusion: Women are much more likely to suffer from osteoporosis than men.

Osteoporosis Risk Factors

According to NIH, there are many risk factors, which can lead to bone loss, and osteoporosis. Several risk factors, you cannot change, but others you can. The following are risk factors you cannot change:

Gender
Women are much more likely to suffer from osteoporosis than men.

Age
The older you are, the greater your risk of osteoporosis.

Body size
Small, thin women are at greater risk of osteoporosis.

Ethnicity
White, Caucasian and Asian women are at highest risk. Black and Hispanic women have a lower risk.

Family history
Osteoporosis tends to run in families. If a family member has osteoporosis, or breaks a bone, there is a greater chance that you will too.

Other risk factors, which you can avoid includes:

Sex hormones
Low estrogen levels due to missing menstrual periods, or having menopause can cause osteoporosis, in women. Low testosterone levels can bring on osteoporosis, in men.

Anorexia nervosa
An eating disorder which can lead to osteoporosis.

Calcium and vitamin D intake
Diet low in calcium and vitamin D, will make you more prone to bone loss.

Activity level
Lack of exercise, or long term bed rest can cause weak bones.

Cigarettes smoking
Smoking impairs muscle, bone, and joint health.

Excessive use of alcohol
Drinking too much alcohol can cause bone loss, and broken bones.

Medication use
Using certain medications to treat rheumatoid arthritis, endocrine disorders, seizure disorders, and gastrointestinal diseases, may have side effects which can damage bone, and lead to osteoporosis.

In his book, dr. Perricone said that glucocorticoids, a class of drugs, a group of steroids, which have metabolic and anti inflammatory effects, have particularly damaging effects on the skeleton.

The following drugs also can cause bone loss:

• Thyroid hormones.
• Anticonvulsants.
• Antacids containing aluminium.
• Gonadrotopin releasing hormones, used for treatment of endometriosis.
• Methotrexate, used for cancer treatment.
• Cyclosporine A, an immunosuppresive drug.
• Heparin and cholestyramine, used for controlling blood cholesterol levels.