Forms of osteoporosis
Osteoporosis is pathogenically divided into two different subtypes, primary and secondary osteoporosis. Within these sub-areas, different types are distinguished from each other. This explains, for example, the distinction between primary osteoporosis.
of type I and primary osteoporosis. of type II, which will be discussed below. Primary osteoporosis of type I:The so-called postmenopausal osteoporosis usually affects women between 50 and 70 years of age.
As already described in epidemiology, about 20 – 40% of all women develop osteoporosis during the menopause. The main cause for the development of postmenopausal (= post-menopausal) O. is scientifically attributed to the deficiency of the female sex hormone “estrogen”. This is a deficiency that is triggered by the hormonal changes during the menopause and disrupts the balance between bone formation and breakdown, which ultimately results in the loss of bone mass.
In the first instance, the spongy bone structure, the so-called cancellous bone, is damaged. This damage is responsible for the fractures that easily occur in the area of the vertebral bodies, ribs, the neck of the femur or the forearm bones (ulna and radius). A targeted prophylaxis to avoid the deficiency of the sex hormone “estrogen” is, for example, the intake of so-called hormone replacement products, the change of diet to a balanced and calcium-rich diet, combined with a high level of exercise.
Since women and men from the age of 70 are affected by this form of osteoporosis in the same way, the synonymous use of the term “senile” osteoporosis is almost self-explanatory. In contrast to Type I, not only is the cancellous bone, the spongy bone structure, damaged here, but the damage also extends to the massive bone substance, the so-called “compacta”, with the result that the so-called tubular bones, such as the thigh or forearm bones (= radius and ulna) break with above-average frequency. The main cause for the development of this type of osteoporosis is initially considered to be the natural aging process.
Combined with a lack of calcium and/or vitamin D and/or lack of exercise, the development of osteoporosis can be intensified. Based on this, the following statements can be made for prophylaxis: Only little can be done against the natural aging process of the bones. The more strongly one should pay attention to a balanced nutrition, under circumstances and supplementation of the food with calcium and vitamin D. Since exercise is specifically mentioned as a prophylactic measure, a high degree of exercise, for example in the form of walks, is beneficial.
This form of osteoporosis can be described as relatively rare, since only about 5% of all osteoporosis diseases are called secondary osteoporoses. In 100 osteoporosis patients “only” about 5 patients are affected by secondary O. Just as in “senile osteoporosis”, women and men are affected by secondary osteoporosis in the same way.
This is due to the fact that the secondary form of O. is always the result of a specific underlying disease. These are, for example, specific hormone-producing tumors (e.g. plasmocytoma), hyperfunctions of the adrenal cortex, hyperfunctions of the thyroid gland, disorders of the parathyroid gland, gastrointestinal diseases with underlying malabsorption of food (e.g.
lactose intolerance), or hereditary connective tissue diseases (e.g. Marfan syndrome), etc. It should be noted that secondary O. runs similar to primary osteoporosis: Due to the imbalance between bone formation and bone resorption, substance loss occurs and the resulting consequences are more or less easily occurring bone fractures. The attending physician can clarify the various possibilities of the causes individually, make diagnoses and initiate therapies.
