Is osteoporosis also "gender-discriminatory"?

This is the 4273rd article of Da Yi Xiao Hu

Real life examples

Aunt Zhang, Mr. Zhang and their two sons live in Xingfu Community in harmony. The younger of the two sons is about to enter school, and the older one is about to graduate. After decades, the two boys have finally grown up and can live independently. The couple can finally hold on to their savings and pursue their long-forgotten dream of traveling around China. One day, Aunt Zhang was on her way home from shopping and passed by the Xingfu Community Health Service Center. She saw a sign on the door saying that it provided free osteoporosis screening, so she stepped into the service center and signed up for the screening for both of them. The next day, Aunt Zhang and Mr. Zhang did the screening together. The result showed that Aunt Zhang had reduced bone mass, while Mr. Zhang was normal. Why is this?

Surveys show that among people over 50 years old, women are four times more likely to suffer from osteoporosis than men, and are twice as likely to suffer from bone loss as men. In addition, the incidence of osteoporosis in women increases three times after the age of 70, while that of men increases two times after the age of 80. The incidence of osteoporosis in women is higher than the combined incidence of other gynecological diseases such as breast cancer, ovarian cancer, and endometrial cancer. The large gender difference in the incidence of osteoporosis between men and women can be attributed to the mechanism of the disease. After menopause, the estrogen secreted by the ovaries of women decreases sharply, which in turn breaks the balance between osteogenesis and osteoclastogenesis. When the estrogen in the body decreases, the number of osteoclasts increases and their functions are enhanced, just like a large number of demolition workers, each of whom is extremely efficient in demolishing a house. On the other hand, osteoblasts that promote bone formation cannot make up for the damage caused by osteoclasts. Therefore, under long-term changes in hormone levels, even a slight external force, such as squatting, bending over, or holding a child, can cause brittle fractures, which is "the house collapses."

Postmenopausal osteoporosis generally occurs between 5 and 10 years after menopause. Because osteoporosis specifically targets postmenopausal women, older female compatriots need to be vigilant and conduct regular bone density tests. It is recommended that women over 65 years old should have regular bone density checks, and men over 70 years old. The World Health Organization recommends dual-energy X-ray (DXA) for measuring bone density, and other methods include the use of ultrasonic bone densitometers, CT, etc. Most hospitals do not provide physical examination packages that include bone density tests, and you need to register for an orthopedic outpatient clinic to request an examination. There is currently no consensus on the frequency of bone density tests, which mainly considers the individual's bone quality and the results of the first test. Because bone density changes slowly, bone density tests do not need to be performed frequently, generally no more than once a year. Of course, before going to the hospital to measure bone density, you can also take a one-minute quick test to screen for osteoporosis risk by answering the following questions.

The most serious complication of osteoporosis is fracture, which most often occurs in the spine, hip and radius. In order to do your best to avoid the consequences of osteoporosis, it is recommended to use the online screening tool FRAX

FRAX

https://www.sheffield.ac.uk/FRAX/tool.aspx?lang=cht

Enter the URL and search to be directed to the FRAX fracture risk assessment page. Follow the instructions to fill in your personal information and bone density test results to get a free assessment of your risk of osteoporotic fractures within ten years.

Once it is assessed that you have bone loss, osteoporosis, or a higher risk of fracture, you should go to the hospital as soon as possible, listen to the doctor's professional advice, adopt lifestyle interventions, or even drug treatment.

Author: Chen Weixin, Lin Hong, Li Juan

Instructor: Dong Jian

Unit: Department of Orthopedics, Zhongshan Hospital Affiliated to Fudan University

Institute of Medical Science Popularization, Fudan University

This article was funded by the following project: Shanghai Science and Technology Commission Science Popularization Project

(No.: 20DZ2312000, 21DZ2302900)