Osteoporosis occurs when the body absorbs bone faster than new bone can be formed. Healthy bone has pores in it, much like the holes in Swiss cheese. The larger the holes, the less Swiss cheese to eat. Bones and osteoporosis are similar: the larger the pores, the lower the bone mass. Bones become fragile and can easily break or fracture. Bone loss is gradual and painless-until a bone breaks. If bone is lost from the spine, vertebrae collapse and become wedge shaped, causing the spine to curve unnaturally. Osteoporosis often occurs in the hip, and a hip fracture can occur from a fall from a standing height. Wrist fractures are also common.

Ten million Americans have osteoporosis, and 34 million have low bone mass, or osteopenia. More than 1.3 million osteoporotic fractures occur annually in the United States, including about 245,000 hip fractures in women and about 80,000 hip fractures in men. After a hip fracture, 12 percent to 20 percent of patients have an increased likelihood of dying in the following year from complications such as pneumonia or a blood clot in the lung. Twenty-five percent require long-term institutional care. Spinal fractures increase patient death rate by 4 percent.

In women, declining estrogen levels after menopause can cause osteoporosis, and in men, declining testosterone levels can cause osteoporosis. Other risk factors for both sexes include nicotine and excess alcohol consumption; inadequate intake of calcium and vitamin D; medications such as steroids, antiseizure and prostate cancer drugs; long-term use of heparin and Coumadin; immobilization or a sedentary lifestyle; multiple myeloma or any marrow-replacing disorder; partial gastrectomy and malabsorption disorders.

To reduce your osteoporosis risk:

• Stop smoking and consuming excessive alcohol (drink no more than two to three ounces a day).
• Do weight-bearing exercise and balance training to prevent falls.
• Take the recommended amounts of calcium and vitamin D throughout life, starting in infancy. Ask your VA healthcare provider how much vitamin D and calcium you should take.

Various medications are available to treat osteoporosis. These medications work by reducing bone loss and increasing bone density. Ask your physician which medication is appropriate for you. Have your height measured yearly. If you believe you've become shorter, tell your VA provider, since this may be a sign of osteoporosis.