Menopause : Complications

Postmenopausal bleeding may occur. This bleeding is often nothing to worry about. However, your health care provider should always check any postmenopausal bleeding. It may also be an early sign of other problems, including cancer. Decreased estro...

Menopause is a natural condition of aging. Some women have no problems at all with menopause, while others notice significant unpleasant symptoms. A wide array of treatments, from natural to hormone replacement, mean that no woman needs to suffer ...

Menopause is a natural condition of aging. Some women have no problems at all with menopause, while others notice significant unpleasant symptoms. A wide array of treatments, from natural products to hormone replacement, mean that no woman needs t...

Osteoporosis is the thinning of bone tissue and loss of bone density over time.

Osteoporosis , which is characterized by a decrease in the mass of otherwise normal bone is the most common metabolic bone disease. Normal bone is made of a hard outer shell (the cortex) and an inner network of spicules (fibers), called trabeculae, that give bone its characteristic strength. Bone mass is maintained at a progressive and then constant level until around the age of thirty-five. This maintenance is accomplished through bone remodeling, a cycle of breaking down and building up of bone. This cycle is controlled by osteoblast cells, which make bone, and osteoclast cells, which destroy bone. Beginning around age forty, the rate at which bone breaks down can exceed that at which it is built, resulting in diminished mass and a diminished amount of calcium in the bone. For women, in addition to this normal age-related bone loss, menopause and its subsequent reduction in female hormone levels (specifically estrogen ) cause a specific loss in cortical and trabecular bone. In those who develop osteoporosis, the reduction in cortical and trabecular bone can be up to 30-40 percent, resulting in fragile bones that are prone to fracture. Several factors contribute to the development of osteoporosis. Smoking, alcohol, and a sedentary lifestyle have all been shown to increase the risk of developing the disorder. Age and gender are also contributory factors. Women who have low estrogen levels (e.g., after menopause) are more likely to develop osteoporosis than others. Also, men generally maintain a higher bone density than women, making them less susceptible to the condition. Race can also play a role. Africans and people of African descent, for example, have a naturally higher bone density than Europeans and people of European descent and are therefore less likely to develop osteoporosis. A family history of osteoporosis certainly predisposes an individual to the An elderly woman exhibits a dowager's hump, which is one symptom of osteoporosis. The hump is caused by repeated compression fractures of weakened vertebrae, which cause the upper spine to curve forward. [© Lester V. Bergman/Corbis. Reproduced by permission.] condition, and research is currently underway to identify genes linked to it. Other risk factors include long-term steroid therapy, Cushing's disease, hyperparathyroidism, and hyperthyroidism. Traditionally, low intake of calcium and vitamin D , both of which are essential to bone building and maintenance, have been associated with osteoporosis as well. However, the role of dietary calcium remains controversial. Countries in Europe and North America, where the dietary intake of calcium is adequate, still show very high rates of osteoporosis. Studies have shown that high-protein diets, like those found in Europe and North America, raise the body's calcium requirement, thereby creating a calcium deficit in some. One of the difficulties in understanding and managing osteoporosis is that its signs and symptoms are not apparent until the late stages of the disease, and many people with the osteoporosis are not diagnosed or treated until a fracture occurs. Hip and wrist fractures are very common, and vertebral compression fractures can occur with as little stress as that from sneezing or bending. These compressions can cause chronic backaches or cause patients to seemingly "lose height" as the vertebrae progressively curve into what is known as the "dowager's hump." Fractures also occur in the ribs, pelvis, and humerus (upper arm bone). Hip fractures can be the most devastating, often leading to death or long-term disability. The most commonly used method to diagnose osteoporosis is to measure bone mineral density using dual energy X-ray absorbitometry (DEXA scans). This test is performed routinely in people who have risk factors or a prior diagnosis of osteoporosis. Density is usually measured in the lower spine or the hip, and the procedure is noninvasive and well tolerated. Quantitative CT (computerized tomography

Osteoporosis (literally "porous bone") is a condition characterized by bone fragility and fracturing. The World Health Organization (WHO) defines osteoporosis as a 25 percent reduction of bone mineral density (BMD) compared to that of a healthy young adult female. Eight million Americans have osteoporosis, and over 20 million have osteopenia (thin bones, or a loss of 10 to 25% of bone mineral density). Osteoporosis is most prevalent in Caucasians, less prevalent in Hispanics, and least prevalent in African Americans. Key predisposing factors are early menopause and a family history of osteoporosis. Other medical, psychological, and social factors may also contribute to the condition. Osteoporosis commonly leads to fractures. Medical, social, and environmental factors that predispose people to osteoporosis-related fractures include impairment of hearing, vision, balance and cognition; debilitating illnesses; medications; postoperative conditions; and unsafe environments. In the United States, one of three females over age sixty-five will have at least one vertebral fracture. The ratio of female to male fractures of a hip is 2.5 to one. Two hundred and fifty thousand hip or wrist fractures and 500,000 vertebral fractures occur annually in the United States. Up to 15 percent of hip fractures will result in death within one year, and one of three survivors become long-term nursing home residents. The annual cost of osteoporosis in the United States is estimated to be as high as $18 million and is projected to reach $240 million by the year 2040. There are several methods to measure bone mineral density for osteoporosis detection. The most precise is dual energy X-ray absorptiometry (DXA) of the hip. Blood and urine tests for bone resorption and formation are also used to help measure the response to therapy. The four components of treatment are nutrition, medication, exercise, and safety. Nutritional factors are particularly important during childhood and adolescence when the bones are growing. Key components are calcium and vitamin D, supplemented by magnesium; and vitamins C and K for individuals with chronic diarrhea or on a low-vegetable diet. Hormonal therapies—estrogens for postmenopausal females and testosterone for hypogonadal males—are widely utilized. Estrogens may be contraindicated by breast or uterine cancer or by susceptibility to vascular clotting, and prostatic disorders may preclude the use of testosterone. Bisphosphonates are potent antiresorptive drugs that can yield reductions in hip and vertebral fracturing. Use of calcitonin, another antiresorptive drug, has also shown reductions in vertebral fracturing. Exercise and safety are essential components of fracture prevention. Vigorous weight-bearing activities are beneficial but not feasible for the elderly or infirm. Walking has not proved efficacious. Resistive exercises increase the muscle strength and bone mineral density essential to fracture prevention. Balance–enhancing activities such as dancing, careful attention to minimizing hazards in the home and work environments, and selective use of padded hip protectors for the aged and infirm all help reduce the risk of osteoporosis-related fractures. Osteoporosis is a major and growing public health concern. Appropriate screening to identify those who are susceptible, accurate diagnosis of osteoporosis and related disorders, and prompt institution and monitoring of appropriate therapies are all essential to minimize the risks of fracture and the attendant mortality and morbidity. R OBERT L. S WEZEY ( SEE ALSO : Hip Fractures )

The word osteoporosis literally means "porous bones." It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium . Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.

The word osteoporosis literally means porous bones. It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium . Over time, bone mass, and therefore bone strength, is decreased. As a result, the bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.

The word osteoporosis literally means "porous bones." It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Over time, bone mass, and therefore bone strength, is decreased. As a result, bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissues, leading to bone fragility and, consequently, an increase in fracture risk.

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissues, leading to bone fragility and, consequently, an increase in fracture risk.

Heart disease is any disorder that affects the heart's ability to function normally. Various forms of heart disease include: Alcoholic cardiomyopathy; Aortic regurgitation; Aortic stenosis; Arrhythmias; Cardiogenic shock; Congenital heart disease; Coronary artery disease (CAD; Dilated cardiomyopathy; Endocarditis; Heart attack (myocardial infarction; Heart failure; Heart tumor; Hypertrophic cardiomyopathy; Idiopathic cardiomyopathy; Ischemic cardiomyopathy; Acute mitral regurgitation; Chronic mitral regurgitation; Mitral stenosis; Mitral valve prolapse; Peripartum cardiomyopathy; Pulmonary stenosis; Stable angina; Unstable angina; Tricuspid regurgitation.

The heart, which is about the size of a human fist, is the body's largest, strongest, and most important muscle. The heart continuously pumps blood through the body, helps regulate and prolong health, and controls the flow (circulation) of blood to the lungs, organs, muscles, and tissues in the body. Heart disease is a leading cause of debilitation and death worldwide in men and women over age sixty-five. In many countries heart disease is viewed as a "second epidemic," replacing infectious diseases as the leading cause of death. It is especially devastating in countries that do not have adequate health care. There are many types of diseases and disorders that affect the heart.

Heart disease is the narrowing or blockage of the arteries and vessels that provide oxygen and nutrient-rich This illustration shows hypertrophic muscle in the heart. The lesions are due to an incompetent aortic valve. ( Illustration by Bryson Biomedical Illustrations, Custom Medical Stock Photo . Reproduced by permission. ) blood to the heart. It is caused by atherosclerosis , an accumulation of fatty materials on the inner linings of arteries that restricts blood flow. When the blood flow to the heart is completely cut off, the result is a heart attack because the heart is starved of oxygen.

Unintentional weight gain is an increase in body weight that occurs when a person takes in more calories than the body needs or uses.

The term overweight is used to describe an excess amount of total body weight including all tissues (fat, bone, muscle, etc.) and water. Obesity , in contrast, is an excess amount of body fat. An adult woman or man who has a body-fat percentage exceeding 35 percent (for women) or 25 percent (for men) is considered obese . A person can be overweight without being obese, as many professional football players and bodybuilders are, for such individuals have large amounts of muscle but not much fat. Likewise, a person can be obese without being overweight, such as some elderly individuals or lazy "couch potatoes," who may not weigh a lot but have too much body fat. However, almost all obese people are also overweight. Because body fat is very difficult to measure accurately, height and weight are used to estimate overweight and obesity. Body mass index (BMI) is a formula that combines both height and weight. It is computed as weight in kilograms divided by height in meters squared, or as weight in pounds times 703 divided by height in inches squared. Normal weight for adults is represented by a BMI of 18.5 to 24.9; overweight by a BMI of 25 to 29.9; and obesity by a BMI of 30 or greater. SEE ALSO O BESITY ; W EIGHT L OSS D IETS ; W EIGHT M ANAGEMENT . John P. Foreyt

Incontinence is the inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine. The three main types of urinary incontinence are: Stress incontinence - occurs during certain activities like coughing, sneezing, laughing, or exercise; Urge incontinence - involves a strong, sudden need to urinate followed by instant bladder contraction and involuntary loss of urine. You don't have enough time between when you recognize the need to urinate and when you actually do urinate; Mixed incontinence - contains components of both stress and urge incontinence. Bowel incontinence, a separate topic, is the inability to control the passage of stool.

Urinary incontinence is unintentional loss of urine that is sufficient enough in frequency and amount to cause physical and/or emotional distress in the person experiencing it.

Urinary incontinence is unintentional loss of urine that is sufficient enough in frequency and amount to cause physical and/or emotional distress in the person experiencing it.