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Osteoporosis is the world’s most common bone disease, being almost universal in older women owing to postmenopausal hormonal changes and a decrease in activity. Half of all women over 45 years old have some X-ray evidence of osteoporosis, and by age 75 years that proportion increases to 90%. Osteoporosis also occurs in younger women as part of the ‘female triad’. Osteoporosis is a reduction in bone mineral density due to an imbalance between resorption and formation. The bone most frequently affected is the trabecular bone at the distal end of the radius in the wrist, the vertebral bodies of the spine, and the neck of the femur. Risks for primary osteoporosis may be genetic, hormonal, nutritional, or related to lifestyle, such as exercise. Secondary osteoporosis may be caused by underlying disease or drugs.
Bone consists of collagen and a mineral structure of calcium and phosphorus which gives the bone its hardness. Inactivity, aging, hormonal and nutritional problems may cause the bone to lose its calcium to varying degrees, making it more susceptible to injury. As well as major fractures, microfractures (fractures that are not immediately visible) are more likely to occur as the bone weakens.
Physical activity increases bone density in most people and should be recommended to all. Regular exercise maintains bone mass in postmenopausal women and improves the overall health. Calcium
supplements may be used for prevention, but only under medical advice. Good diet is a necessity. When osteoporosis causes pain, the person should keep as active as possible, perhaps with the aid of painkillers, to prevent further deterioration and muscle weakness.

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