Disease prevention

Osteoporosis occurs in 30% of women over 60 years of age. It generally develops asymptomatically and is not detected until the appearance of a fracture. There are several risk factors for the development of osteoporosis:

• weight: slim women are at higher risk.
• Ethnicity: Caucasian and Oriental women have a higher incidence of osteoporosis.
• medications: taking some medications such as corticosteroids increase their incidence.
• certain diseases such as anorexia nervosa, chronic kidney failure, liver failure, diabetes mellitus, multiple myeloma.
• family history: the genetic factor is one of the most influential.
• age: the older the greater the risk of osteoporosis.
• habits: tobacco, alcohol, sedentary lifestyle, tea and coffee intake, and diets poor in calcium are risk factors.
• early menopause; If menopause occurs before age 40, the risk of osteoporosis increases.
• nulliparity: women who have not had children have a higher incidence of osteoporosis.

To prevent osteoporosis, a diet rich in calcium and vitamin D should be taken. Intake of coffee and alcohol should be limited as they cause a decrease in the absorption of calcium from the diet. Tobacco and drugs accelerate menopause by neuroendocrine alteration and by vascular action on the ovary. Sunbathing for at least 15 minutes a day with adequate sun protection favors the formation of vitamin D necessary for the prevention of osteoporosis. Moderate physical exercise, such as walking at a good pace for 30 minutes 3-4 times a week, is also preventive for bone loss.

Bone densitometry is a simple test that indicates the amount of bone mass in the bones. If osteoporosis has already appeared, in addition to recommending a healthy lifestyle, the taking of drugs that inhibit bone destruction, such as bisphosphonates or calcitonin, may be indicated. To a lesser extent, drugs that increase bone formation are used.

To reduce cardiovascular disease, you should eat a low-fat diet, eliminate tobacco, exercise moderately, and get regular check-ups.

Hormone replacement therapy (HRT) is hormonal treatment with estrogens alone or with progesterone, mimicking the production of hormones by the ovary. This treatment aims to reduce osteoporosis, decrease cardiovascular risk and climacteric symptoms. This treatment has been much discussed after some American studies but they maintain certain clear indications, such as early menopause, osteoporosis and important climacteric symptoms. This treatment does not influence the weight gain of menopause and does not increase the risk of breast cancer if the recommended treatment time of 5 years is not exceeded. There are also contraindications to treatment such as: previous breast cancer or hormone-dependent cancer, vaginal bleeding without a diagnosed cause, severe liver disease, history of thromboembolic disease, pregnancy. Relative contraindications are major varicose syndrome, diabetes, moderate liver disease, obesity, smokers of more than 20 cigarettes / day, severe high blood pressure, and a history of endometrial cancer. HRT will be given in the smallest dose necessary and for the shortest time possible. HRT has a positive effect on the vasomotor symptoms of menopause, on the prevention of bone loss, and on cardiovascular risk.

The alternatives to hormonal treatment are non-hormonal treatments such as phytoestrogens, black cohosh, evening primrose oil Phytoestrogens or soy isoflavones, are derived from plants and act as weak estrogens at the skeleton, cardiovascular system and system level central nervous without effects on the genital tract or breast. They are an alternative to hormonal treatment when it is contraindicated.