June 22, 2009 -- Secretary of State Hillary Clinton's unfortunate fall last week meant a fracture and subsequent surgery Friday to repair the break in her right elbow.
It's not clear if this was just a nasty fall or if Clinton has any underlying conditions such as osteoporosis that contributed to the fracture. Her spokesperson declined to comment about whether she'd received any such diagnosis after the accident.
Regardless, for many women who are roughly the same age as Clinton this is the kind of accident that often serves as a wake-up call that they should get themselves screened for the bone-weakening condition osteoporosis and its precursor, osteopenia.
Clinton, 61, reportedly fell in the State Department basement as she was on the way to a meeting and heading to her car.
But for about 10 million Americans who have osteoporosis in this country -- roughly 8 million of whom are older women -- a broken bone is often the first, and only, warning of osteoporosis.
"There are no symptoms until the first break, so you'll know if you get a simple fracture from a simple fall," ABC News medical contributor Dr. Marie Savard said this morning on ABC's "Good Morning America." And she added that the drop in hormone production that accompanies menopause signals an increased risk for the condition.
"All post-menopausal women are at risk," Savard said. "The older you are, the more at risk you are."
But not everyone who is at risk for osteoporosis knows it -- possibly due to the incorrect stereotype that only frail, old women experience the condition. As a result, only about 20 percent of women who have a telltale fracture from osteoporosis -- most often in the spine, hip or wrist -- ever get properly diagnosed and treated.
Are You at Risk of Osteoporosis?
Osteoporosis is a condition in which the bones become brittle and more likely to break. The condition is a silent one, usually progressing painlessly until a bone break occurs.
In addition to the 10 million Americans who have already received a diagnosis of osteoporosis, nearly 34 million more are believed to have low bone mass, which places them at increased risk for osteoporosis, according to the National Osteoporosis Foundation.
While women are about four times as likely as men to suffer from the condition, there are other factors that can also put individuals at risk. These include small body size, Caucasian or Asian ethnicity and a family history of the condition. Certain medications, such as certain steroids and drugs to control seizures, can also increase the risk for osteoporosis.
Getting Yourself Tested for Osteoporosis
Women who are concerned that they may be developing osteoporosis can opt for a bone density scan, which measures the mineral density of an individual's bones compared with that of an average, healthy 35-year-old woman's bones. The result, called a T-score, is an important indicator of osteoporosis risk, particularly for post-menopausal women.
A T-score of -1 or above indicates that an individual's bones are at least as strong as those of a healthy 35-year-old woman's. A T-score between -1 and -2 indicates the low-bone-mass condition known as osteopenia, and a score lower than -2 signifies osteoporosis.
Medicare guidelines call for this test in women who are 65 years old, though younger women with multiple risk factors are also encouraged to get bone density screening. The test costs about $150, so even for women who are not yet covered by Medicare, the cost is not prohibitive.
Staving off Bone Weakness
Fortunately, Savard said, there are steps that women can take to lessen the likelihood that they will have a problem with osteoporosis, even if they score well on a bone density test.
If you've got a healthy result, there are three things to do," Savard said. "Take a calcium supplement of 1,500 mg per day, and at least 1,000 units of vitamin D.
"And you need to exercise," she added. "Walking is great, but you need to build muscle mass with weight bearing exercise at least three times a week."
The third thing that women can do if they have risk factors for osteoporosis is to start taking drugs like Fosamax and Boniva, Savard said.
Younger Women Can Protect Themselves From Osteoporosis
If there is anything else to bear in mind, Savard said, it is that there are also steps that younger women can take when it comes to preventing the bone-robbing disease.
"Just build up as much muscle and bone mass as you can with strength training and vitamins," she said. "The more you have stored up when you hit menopause, the more you'll have after it's over."