About 25 million Americans have the bone-thinning disease osteoporosis -- and many of them don't know it. This "silent disease" often produces no symptoms until a weakened bone breaks. Such fractures, usually in the spine, hip or wrist, occur in more than 1 million adults annually. Half of all Caucasian women age 50 and older can expect to have a bone fracture due to osteoporosis at some time during their lives.

Some people have a higher likelihood of getting osteoporosis than others. Risk is increased if you have a limited lifetime exposure to estrogen, for example, if you enter menopause earlier than your late 40s. Long-term use of corticosteroid medications (such as those for asthma or rheumatoid arthritis) and some other medications also increase your risk.

Osteoporosis is not an inevitable part of aging. It's largely preventable, especially if you start prevention in your early years. A diet high in calcium and regular exercise throughout your lifetime, and hormone replacement therapy after menopause are the best means of prevention. Drugs called bisphosphonates can also help prevent osteoporosis and can even rebuild bone tissue in older people.

It is especially important to consume enough calcium through diet and, if necessary, calcium supplements. Adult women need about 1,000 mg per day before menopause; during adolescence and after menopause, about 1,200 mg is the goal. Dairy products are very high in calcium, as are fortified orange juice and some vegetables. If you find that you aren’t reaching these calcium intake goals, you may want to speak to your physician about calcium supplements.

Taking hormone replacement therapy (estrogen) during and after menopause can be very beneficial in the prevention of osteoporosis. Studies have found that estrogen users are at least 25 percent less likely to suffer a fracture than nonusers. The earlier you start this regimen, the more protection you gain. 

Hormone replacement therapy is not without some risks or side effects, including an increased risk for breast cancer. Your doctor can help you decide whether hormone replacement therapy is right for you.

Weight-bearing exercise is another way to substantially reduce your risk. This includes any activity done on the feet with the bones supporting the body's weight. Exercises in which bones sustain repeated impact -- such as walking, running and playing tennis -- are good for prevention. Bones also respond to the force of muscles pulling on them (strength-training exercise). Weight machines or free weights (even lifting cans of food) can be very beneficial. A combination of both types of exercise works best. Walking mainly affects the bones in the legs, hips and lower spine, while strength training builds muscles and bones in the arms and upper spine.

Although it's best to prevent osteoporosis in the first place, there are ways to detect bone loss in its earliest stages so that it can be treated before fractures occur. Your physician can arrange a simple assessment of your bone status and recommend treatment as needed. If you don’t already have a physician, call the Health Alliance physician referral line at 1-888-749-DrDr or click here.

The Health Alliance is a presenting sponsor of the fifth annual Speaking of Women's Health Conference in Cincinnati held March 15 -19. The theme of this year's event is "Strong Women Have Strong Bones."