Osteoporosis is one of the most common bone diseases – a health condition that weakens bones by accelerating bone mass loss, which makes bones porous, fragile, and susceptible to fractures.

Interestingly, this condition is more common in women than men, and its prevalence increases with age. Often, people don’t know they have the condition until they suffer from a fracture or have developed significantly porous and weak bones. It is known to develop slowly over a number of years.

Osteoporosis occurs as your bones change over time. In reality, your body naturally removes old, damaged bone and replaces it with new bone every 7 to 10 years after you become an adult. This process is called bone remodelling.

What is Bone Remodelling

Balanced bone remodelling: Before age 30, especially around the time of puberty and early adulthood, people can make bigger, thicker bones with weight-bearing exercise and good nutrition. Until about age 30, your body makes new bone at about the same rate as the old bone tissue is removed; in other words, bone remodelling is balanced.

Unbalanced bone remodelling: After age 30-40, bone remodelling may gradually become unbalanced. You start to remove old bone more quickly than your body can replace it — leading to a loss of both bone density and architecture, which decreases the strength and quality of your bones as you age.

Weakened bone can also occur in both men and women at younger ages due to various causes, including poor nutrition and a sedentary lifestyle.

The first sign that low bone mass has progressed to osteoporosis can be suffering a broken bone from a minor injury that probably would not have caused a fracture in a healthy person. For example, if you trip over an object in your home and break your wrist, this is most likely because of underlying bone weakness. A person with normal bone strength is not likely to break a wrist or hip from this small amount of trauma. Similarly, if you lift bags of groceries or push up a heavy window and sustain a spinal fracture, it’s also likely to be due to osteoporosis.

Recent studies have shown that even fractures caused by greater degrees of injury than simple falls, such as car crashes, can be associated with bone weakness.

Main causes of Osteoporosis

  1. Aging

With aging, the thick outer shell of the bone (cortex) becomes thinner, and the architecture in the spongy bone also becomes thinner and less connected. This causes structural weakness in the bone that leads to fractures.

  1. Hormonal Changes

The levels of certain sex hormones — oestrogen in both sexes and testosterone in men — are involved in the process of building and remodelling bones:

Oestrogen levels in women drop quickly at menopause.

In men, loss of sex hormones occurs more slowly with age, though some men experience testosterone deficiency (hypogonadism) at a younger age.

Sex hormone loss and other aging factors increase the rate of bone turnover, causing more bone to be removed than replaced and leading to progressive bone loss.

  1. Genetic Predisposition

Your risk increases if you have:

  • A family history of osteoporosis
  • A history of fractures on your mother’s side of the family
  • Additional Risk Factors for Osteoporosis
  1. Certain other factors can increase your risk of osteoporosis independent of your bone density, age, or gender.
  • Medications
  • Health Conditions and Procedures
  • Poor Nutrition
  • Lifestyle Choices

Doctor Examination

At a routine health checkup, your doctor might look for signs of osteoporosis, such as significant height loss with age. This is especially important if you have a family history of osteoporosis, have any medical diagnoses that increase fracture risk, or are taking medications that can lead to bone loss.


Here are some of things that can help you take control of osteoporosis and symptoms associated with the condition:

  • Healthy eating plan, including foods rich in calcium and vitamin D
  • Taking calcium and vitamin D supplements
  • Regular exercise to prevent bone loss and increase bone density. Example: weight bearing exercises, such as walking are ideal
  • Making lifestyle changes such as giving up smoking and reducing alcohol consumption
  • Seek additional care when required (endocrinologists, physical therapy, nutritionists, and dieticians)

An orthopaedic doctor can help you take control of the condition and improve your quality of life as they are experts in conditions, injuries, and diseases associated with the musculoskeletal system, including conditions like osteoporosis.

This article ” Osteoporosis”  does not provide medical advice and is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Please consult a doctor for all medical advice. 



Meet Dr Peter Smith, a leading Orthopaedic Surgeon operating from the Mediclinic Milnerton in Cape Town, Western Cape. His practice is situated in the heart of this seaside town.  Dr Peter Smith not only offers patients the full spectrum of professional orthopaedic treatments, but specialises in total knee replacement, total hip replacement, sports injuries and the latest arthroscopic surgery techniques and computer guided surgery. He gained extensive experience in the latest arthroplasty techniques during his stay of 6 years in Australia where he performed more than a hundred primary and revision hip and knee replacements cases in a year.

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