Two to three million French women are affected by this disease. To replenish the bone capital and avoid the risk of fracture, there are several kinds of drugs.
Osteoporosis is a bone disease. Gradually losing its density, it becomes brittle and breaks easily. The aim of the treatment is to increase its resistance, therefore to avoid fractures.
These can be particularly serious from a certain age, especially if they are located at the level of the vertebrae and the neck of the femur.
By losing their autonomy, the elderly see their life expectancy decrease. Studies have shown that the risk of death unfortunately increases after a hip fracture.
The diagnosis is established from a bone densitometric examination.
Several methods exist. Dual-photon X-ray densitometry measures bone density in the hip or lumbar vertebrae.
This is the method commonly used in France . But another technique, which uses ultrasound, is developing. The measurement is taken at the level of the heel. Both examinations are absolutely painless.
In France, bone densitometry, which costs between 46 and 183 € depending on the places where it is practiced; it is partially covered (reimbursed at 70% on the basis of a rate set at €39.96).
Menopausal women are primarily concerned , because bone density is linked to the production of estrogen in the body. As soon as this production decreases, the bone becomes more fragile. Two to three million French women are affected by this disease. But from the age of 60-65, women are not equal when it comes to osteoporosis. Some have an additional risk of having the disease.
You must first take into account a hereditary factor . Those whose mother has fractured a limb due to osteoporosis should seek screening. Early menopause and late puberty are also risk factors, as well as thinness, regular use of corticosteroids, vitamin D and calcium deficiencies, prolonged immobility, smoking and alcoholism. Finally, a recent study suggests that depression could facilitate the onset of osteoporosis.
One in eight men is affected by osteoporosis after the age of 50, while the disease affects one in three women in the same age group.
The risk factors are essentially the same.
Hormone replacement therapy (HRT). Recommended for postmenopausal women, HRT slows down bone loss. It prevents and cures osteoporosis. The HRT hormones have benefits and disadvantages:they increase by significantly bone density and act on other tissues. Beneficial about symptoms of menopause, they would be effective in prevention cardiovascular accidents and Alzheimer's disease.
But if the treatment is poorly adapted, there is a risk of vaginal bleeding, weight gain, breast tension and a slight increase in the risk of breast cancer, according to epidemiological studies.
Raloxifene. It is the newest drug. It is a SERM (selective estrogen receptor modulator) that works by increasing bone mass. Studies have shown that after three years of treatment, raloxifene reduces the risk of vertebral fracture by 55%. But its effectiveness on the hip has not been proven. It should be noted that raloxifene significantly reduces the risk of breast cancer (unlike HRT), does not increase the risk of endometrial cancer and reduces cholesterol levels.
Calcium and vitamin D. These two nutrients help build bone capital from a very young age age. They effectively complement osteoporosis treatments. Miscellaneous drugs are based on these two active subtances. On the other hand, calcium is present in significant quantity in dairy products. A contribution 1000 to 1500 mg per day is recommended. Vitamin D is present in fish liver oils, in some fatty fish, egg yolk and butter. It is mainly synthesized by skin under the action of the sun.
The ideal would be to continue the treatment for more than three years in order to consolidate the bone mass. But it is not easy to take long-term medication.
Treatment can be stopped after two or three years, by encouraging the patient to continue taking calcium and vitamin D. A bone densitometry should be repeated two years after treatment has stopped to see if there is a recurrence of osteoporosis.
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