Health Library

Estrogen deficiencies occur as a result of:

• Menopause: Natural or surgical menopause increases your risk of osteoporosis. The risk of fracture increases significantly five years after menopause. Though initial fractures may be in the wrist or spine , these strongly predict the later development of severe osteoporosis and hip fracture .
• Amenorrhea (cessation of menstruation before menopause): Your risk of osteoporosis increases if you miss menstrual periods for three months or longer. Amenorrhea may occur with eating disorders, such as anorexia nervosa and bulimia , or with excessive or intensive exercise, such as long distance running.

These are some other risk factors may increase a woman's risk of developing osteoporosis:

• Family history of osteoporosis
• Gastrointestinal malabsorption
• Having another endocrine disorder (eg, thyroid disorder, diabetes)

In men, deficiencies of testosterone and, to a much minor extent, estrogen play a role in the development of osteoporosis. This may be related to:

• Advanced age
• Certain conditions that reduce testosterone levels (eg, mumps , treatment for prostate cancer )
• Hypogonadism (a severe deficiency in the male sex hormone)

Your risk of developing osteoporosis increases if you have a restrictive diet (eg, not getting enough calcium or vitamin D ). An excess of phosphorous in your diet may increase your risk if your calcium and/or vitamin D intakes are low. Excessive use of alcohol , coffee, or tea may also increase your risk of osteoporosis.

Regular exercise , especially weight-bearing and resistance exercise, helps strengthen bones. Therefore, if you do not exercise on a regular basis, you may increase your risk of developing osteoporosis. Individuals who do not exercise regularly also tend to have weaker muscles and poorer balance, which can lead to falls and fractures.

Smoking impairs bone, muscle, and joint health. If you smoke, you have a higher risk of developing osteoporosis.

Small-boned women and underweight people of both sexes have an increased risk of osteoporosis. Individuals who are short, thin, and have narrow hips are at increased risk of low bone density and fracture.

The effect of sun on the skin is a primary source of vitamin D, which aids bone formation. If you get very little sun exposure and have a low dietary intake of vitamin D, you may be at increased risk of osteoporosis.

Caucasian, Asian, and Hispanic women are more likely to develop osteoporosis than those of other ethnic groups. Though most ethnic studies have focused on women, it is believed that men in these ethnic groups carry a parallel but lower risk.

The long-term use of certain medicines increases your risk of osteoporosis. Examples include:

• Corticosteroids
• Medicines to suppress the immune system
• Chemotherapy
• Hormonal therapy
• Thyroid medicines
• Antidepressants (eg, tricyclic antidepressants, selective serotonin reuptake inhibitors)
• Antiseizure medicines
• Medicines containing aluminum (eg, certain antacids)
• Long-term heparin therapy
• Glitazones (diabetes medicine)

Talk to your doctor before stopping or reducing your medicine.

Certain chronic diseases may increase your risk for developing osteoporosis.

• Cardiovascular disease
• Asthma
• Liver disease (eg, cirrhosis )
• Kidney disease
• Rheumatoid arthritis
• Type 2 diabetes
• Hyperthyroidism
• Hyperparathyroidism
• Cushing’s syndrome
• Sarcoidosis
• Scurvy (vitamin C deficiency)
• Gastrointestinal disorders, especially those causing malabsorption
• Eating disorder
• Alcoholism
• Depression (possibly be due to higher levels of the stress hormone cortisol, which may contribute to loss of bone density)
• Inherited disorders (eg, Marfan syndrome , Ehler-Danlos syndrome , porphyria )
• Cancer (eg, lymphoma, leukemia, myeloma )
• Treatment for cancer (eg, chemotherapy , radiation therapy )
• Organ transplant
• Crohn's disease