Hormone therapy is commonly used to treat menopause symptoms, but can lead to bone loss and osteoporosis over time. Osteoporosis occurs when bone density decreases and bone strength is weakened, increasing the risk of fractures. It often presents without symptoms until a bone breaks. Diagnostic tests like x-rays and bone density scans can detect osteoporosis by measuring bone mass in the spine, hips, and arms. Risk factors include aging, menopause, and some medications. Prevention focuses on calcium, vitamin D, exercise, and osteoporosis drugs.

1. A S E M S H A D I D
PBL 1 - MS

2. HORMONAL THERAPY AND
OSTEOPOROSIS
• Hormone Therapy (HT) or estrogen/progesterone, is commonly
used to relieve the symptoms of menopause.
• Following menopause, the body produces much less of the sex
hormones estrogen and progesterone, resulting in a loss of bone
density.
• In women, bone loss occurs rapidly in the perimenopausal years.
Bone loss can eventually lead to osteoporosis (or thin bones).
• osteoporosis can progress without pain or symptoms until a bone
breaks (fractures). Fractures commonly occur in the hip .
• Half of women and a quarter of men older than 50 years will have an
osteoporosis-related fracture in their lifetime.
• Men in their fifties do not experience the rapid loss of bone mass
that women do in the years following menopause. By age 65 or 70,
however, men and women are losing bone mass at the same rate .

4. DIAGNOSING BONE DISORDERS
• X-ray. An X-ray can show injuries, such as fractures,
infections, arthritis, and other changes.
• Bone densitometry. Bone densitometry is often used to
detect osteoporosis. The test measures bone mass in
the spine, hips, and arms. These are the areas most
likely to fracture when bone mass is low.

5. CON.
• Computed tomography scan (also called a CT or CAT scan). A CT
scan shows detailed images of any part of the body, including the
bones, muscles, fat, and organs. CT scans are more detailed than
general X-rays.
• Magnetic resonance imaging (MRI). An MRI scan provides detailed
images of soft tissue, the bone marrow cavity, and bone tumors.
• Radionuclide bone scan. The bone scan is used to pinpoint the
location of bone tumors, as well as to detect spread to other bones. It's
also used to diagnose stress fractures or tiny cracks in the bones
• Biopsy. Tissue samples are removed and examined under a
microscope. It's done to determine if cancer or other abnormal cells are
present. Two types of biopsy, including:
• Needle biopsy. A needle is inserted into the bone to obtain tissue.
• Open biopsy. A surgical procedure in which an incision is made
through the skin to and allow a sample of tissue to be cut or scraped
away.

6. OSTEOPOROSIS
• Osteoporosis is a term
that describes the loss
of calcium from bones
resulting in bones that
are thin.
• Osteoporosis is a
disease where
decreased bone
strength increases the
risk of a broken bone.

7. CON. OSTEOPOROSIS
• Osteopenia is the forerunner - ‫تسبق‬- of osteoporosis. It is a
silent but destructive condition that robs bones during a
woman's -- even a young woman's -- most productive time.
• Until a broken bone occurs there are typically no symptoms.In
fact, there are usually no visible signs.
• Risk factors for osteoporosis include aging, being female,
low body weight, low sex hormones or menopause, smoking,
and some medications.
• Prevention and treatment include calcium and vitamin D,
exercise, and osteoporosis medications.

8. CON. OSTEOPOROSIS
• What Are Osteoporosis
Symptoms?
• Osteoporosis often progresses
without symptoms or pain. Losing
height may be noticeable. Or a
Dowager's hump in your spine
may develop with age.
• Osteoporosis itself has no
symptoms; its main consequence
is the increased risk of bone
fractures.That fracture is often in
the back or hips.

9. HOW DO I KNOW IF I HAVE OSTEOPOROSIS?
.
• How Do I Know if I Have Osteoporosis?
• First, check your risk factors. Then, ask your
health care provider about a bone mineral
density (BMD) test.
• BMD : is the amount of bone mineral in bone
tissue.
• Results are often reported in 3 terms:
• Measured areal density in g cm−2
• z-score, the number of standard deviations
above or below the mean for the patient's
age, sex and ethnicity
• t-score, the number of standard deviations
above or below the mean for a healthy 30-
year-old adult of the same sex and ethnicity
as the patient

10. CON.
• there are many different types of BMD tests Dual-energy
X-ray absorptiometry (DXA or DEXA) is currently the
most widely used .
• Results :
• Results are generally scored by two measures, the T-
score and the Z-score. Scores indicate the amount one's
bone mineral density varies from the mean. Negative
scores indicate lower bone density, and positive scores
indicate higher.

11. CON.
• The criteria of the World Health Organization are:
• T-score is the relevant measure when screening for osteoporosis. It is
the bone mineral density (BMD) at the site when compared to the
young normal reference mean.
• Normal is a T-score of −1.0 or higher
• Osteopenia is defined as between −1.0 and −2.5
• Osteoporosis is defined as −2.5 or lower, meaning a bone density that
is two and a half standard deviations below the mean of a thirty-year-
old man/woman.
• The Z-score is the comparison to the age-matched normal and is
usually used in cases of severe osteoporosis. This is the number of
standard deviations a patient's BMD differs from the average BMD of
their age, sex, and ethnicity.

12. IN OTHER WORD ..

13. ANATOMY AND HISTOLOGY
OSTEOPOROSIS

15. Illustration depicting normal
standing posture and
osteoporosis

16. THANKS