Primary osteoporosis is the usual form of the disease which most people recognize. It is a problem that occurs within the skeleton, causing it to weaken and fracture with very little trauma. Both men and women can develop it. In women estrogen deficiency at menopause is considered the major cause; in men a specific cause is less clear but aging and all its changes seems to be the most important factor. There are however a large number of diseases that affect the body and secondarily affect the skeleton also. These are called secondary osteoporoses.
Virtually any disease one can think of may in some fashion affect the skeleton. Sometimes this effect is profound and serious, causing significant bone deterioration and weakening. In other cases it is less so. Typically bone densitometry, a clinical history and some blood/urine tests can help physicians decipher the extent of bone involvement.
Many diseases related to hormones other than estrogen cause bone loss. Many drugs used for treatment of non-bone diseases can weaken the skeleton. Commonly recognized ones are anti-seizure drugs, anti-inflammatory agents like steroids(glucocorticoids), and anti-estrogen medications used in therapy of breast cancer. Diseases of the gastrointestinal tract and kidneys are also associated with skeletal problems. Inflammatory bowel disease and the drugs used for its treatment cause osteoporosis. Kidney failure and dialysis cause a very complicated bone disease in which osteoporosis is only part of the total picture.
The treatments for primary osteoporosis and secondary osteoporosis are different in many cases. Hence, primary osteoporosis must be distinguished from secondary causes.
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