Secondary Causes

What are primary causes of osteoporosis?

There are many potential causes for osteoporosis. Some causes are considered primary and others are secondary. Genetics or a strong family history of osteoporosis is a primary cause that can affect premenopausal women. Lifestyle factors are also primary causes for osteoporosis. Lifestyle factors that can contribute to osteoporosis include eating a poor diet especially if it is low in calcium and vitamin D, getting too little physical activity, smoking or using tobacco products, and drinking excessive alcoholic beverages.

What are secondary causes of osteoporosis?

Secondary causes of osteoporosis in the premenopausal years include certain diseases and medical conditions that can interfere with reaching peak bone mass or that can cause bone loss. In addition, certain medications that are necessary to treat medical conditions and diseases, may also increase the risk for bone loss and osteoporosis.

Some of the Secondary Causes for osteoporosis in premenopausal women include the following diseases and medical conditions:

• Amennorhea and hormone/endocrine disorders- The hormone estrogen regulates the menstrual cycle and promotes healthy bones. Conditions or hormonal disorders that reduce estrogen levels in premenopausal women increase the risk for bone loss and may lead to osteoporosis. Amennorhea means the absence of menstrual periods in a non-pregnant premenopausal women. The only healthy and expected reason to stop having menstrual periods during the premenopausal years is pregnancy. Some causes for amennorhea include eating disorders, the athletic female triad, the use of certain medications, thyroid disease, hyperprolactinemia, Cushing's disease, pituitary or hypothalamic disorders, polycystic ovarian syndrome, and uterine adhesions (perhaps due to an infection or recent surgery.
  
  
• Eating disorders- Any eating disorder including anorexia, bulimia, and combination eating disorders that causes disruption of normal menstrual cycles in premenopausal women can lead to bone loss and osteoporosis as well as other life-threatening problems. The eating disorder most commonly associated with osteoporosis is anorexia nervosa. People with eating disorders may purposely restrict food intake, exercise excessively, purge (vomit after eating or chronically use laxatives, diet pills, and/or water pills) or use smoking as an appetite suppressant. All of these behaviors may result in hormonal imbalance and in the case of anorexia nervosa, excessive thinness. It is imperative to speak to your medical professional if you think you may have an eating disorder. Eating disorders must be identified and treated in order to prevent or treat osteoporosis.
  
  
• The athletic female triad(also referred to as the female athletic triad)- This is a syndrome consisting of disordered eating, excessive exercise and amenorrhea that result in bone loss. Bone density is lower in athletes with amennorhea in comparison to athletes with regular menstrual cycles. For more information see: http://www.nysphsaa.org/programs/triad.asp
  
  
• Disabilities and Immobility- Premenopausal women who are immobile for six months or more are at high risk for bone loss
  
  
• Gastrointestinal diseases- such as Crohn's disease, celiac disease or any other gastrointesinal condition causing malabsorption can result in bone loss.

• Organ Transplantation

• Transient osteoporosis of pregnancy - This is a rare condition that affects some women in their third trimester of pregnancy (usually the first pregnancy) or within a few months after the baby is born. It is not clear why this happens or how to avoid this condition. Osteoporosis in pregnancy usually goes away within a few months after the baby's birth. According to medical evidence, this type of osteoporosis does not usually cause long-term osteoporosis.

Some of the medications that may increase bone loss and the increase the risk for osteoporosis in premenopausal women include:

• Steroids (such as prednisone or cortisone) used for more than 3 months to treat asthma, arthritis or other diseases

• Gonadotropin-releasing hormone agonists (lupron or zoladex) used to treat endometriosis

• Untreated overactive thyroid disease, thyroid medications taken in high dosages, or lack of routine blood tests for TSH-level monitoring

• Chemotherapy medications that treat cancer and may cause the early onset of menopause

• There are many other medications known to be secondary causes of osteoporosis