THE FACTS

tablets, anti-epileptic drugs, ancer treatments such as ase inhibitors, and some e cancer drugs. The Depocontraceptive jab is also o affect bone density.

emedical conditions:

toid arthritis, low levels of testosterone in men, low levels of oestrogen in women (eg early menopause, anorexia nervosa, hysterectomy before age 45), Crohn’s, coeliac disease and certain thyroid diseases are linked to osteoporosis.

Smoking:

■ Women who smoke tend to have an earlier menopause, upping their risk, and it seems to affect bonecells.

king too much alcohol:

seems to affect cells that d break down bone and, of course, under the influence, you become unsteady – increasing your risk of falls.

Over-exercising:

■ Over-training, together with not eating enough for endurance workouts, can negatively impact bone health. This is something known as the “female athlete triad” or “relative energy deficiency in sport” (as it can affect men, too).

Diet:

■ People who are vegan or lactose intolerant should ensure they get calcium from other sources, such as tofu, dried fruit, pulses, almonds and broccoli. And be wary about extreme diets that eliminate dairy, warns Sarah. Vitamin D – from exposure to sunlight, oily fish and eggs – is vital for calcium absorption.

Am I at risk?

Osteoporosis doesn’t necessarily have any symptoms. In fact, most sufferers are unaware of their condition until they suffer a fracture. “Broken wrists in middle-age women, following a minor fall or bump, are classic warning signs,” says Sarah. “However, some might notice they suffer back pain or a loss of height.”

If you have had an eating disorder, suffered a fracture after a minor fall, reached the menopause early, have a history of missed periods, or are on a long-term course of corticosteroid drugs, ask your GP for a referral to a specialist for a fracture risk assessment. This may include a bone density (DEXA) scan to help measure your bone strength.

Assess your risk of osteoporosis by taking the Stop at One quiz: stopatone.nos.org.uk

How is it treated?

Drugs to reduce fracture risk act in different ways – reducing resorption or increasing bone formation. Most are antiresorptive drugs that slow down the activity of cells that break down old bone, while anabolic drugs stimulate cells that build new bone. One ■ Osteoporosis is very common. in five men in two women and one break a bone over the age of 50 will because of the condition. have

■ One in five women who three or broken a bone will break with more before being diagnosed osteoporosis. people ■ Treating and looking after caused who have suffered fractures in by osteoporosis costs £4.4billion year. health and social care each