The theme is ‘ Postmenopausal Women And Their Bone Health ‘
Senile osteoporosis occurs in both sexes but women lose more bone mass than men after menopause . Osteoporotic fractures constitute a major public health problem .
Loss of bone mass normally begins in the 4th decade , with the rate of loss accelerating during the 7th decade . These losses occur due to changes in bone remodeling and also change in calcium metabolism that occurs with age . With ageing there is decrease in absorption of calcium from gut and an increase in calcium loss by kidney and skin . This decreased absorption combined with increased loss means greater demand on the reserves of calcium stored in the bone , ultimately leading to bone loss .
The main bone loss is in vertebrae and the hip , 50% of all fractures are vertebral . A large number of women are unable to resume the normal activities . The third most common site for fractures is wrist joint .
In Ayurveda , Asthikshaya can be compared with Osteoporosis .
ASTHI : It is the 5th dhatu among the seven dhatus . Nails , hair are its Malas .
Asthi Dhatu is guru ( heavy ) , khara ( rough ) , kathina ( hard ) , sthula (gross form ) , sthira ( takes long time to disintegrate and changes occur very slowly ) , murtimad ( gives strength ,shape & size to the body and keeps it erect ) . Its function is deha dharana , Majja pushti and it is the seat of Vayu.
Etymology of Asthikshaya :
Asthi is derived from the root ‘As’ + ‘Kthin’ meaning to stay or in the sense of stability .
The definition of Asthi are ‘Asyate kshipyate yat’ ; ‘Asyate iti Asthi’ ; ‘Mamsabhyantarasthah – Shariastha Sapta Dhatvantargata Dhatu Vishesha’ – That which is present in its own state for a long time is called Asthi .
The definition of Kshaya is ‘Kshiyate anena iti kshaya’ , ‘Kshaya vyadhi visheshah’ – That which decreases either qualitative or quantitative is called Kshaya and is vyadhi vishesha .
Thus combined meaning of Asthikshaya is decrease in bone tissue .
Asthi is the main seat of Vata . The increase and decrease of Asthi and Vata are inversely proportional to each other ie when Vata increases , Asthi decreases and vice versa . Hence the factors which cause increase of Vata will cause decrease of Asthi .
OSTEOPOROSIS : The term “Osteoporosis” was coined by Pommer in 1885 which literally means “porous bones”. The word Osteoporosis is comprised of two words i.e.‘Osteo’ and ‘Porosis’. ‘Osteo’ is derived from the Greek word ‘Osteon’ means the ‘bone tissue’ and ‘Porosis’ is derived from the Latin word ‘Porosus’ which means ‘full of pores’. Thus combined meaning of the word Osteoporosis is ‘Porous bones’.
In 1994 World Health Organization (WHO) defined Osteoporosis operationally to be femoral neck Bone mineral density (BMD) value 2.5 standard deviations or more below the mean for normal young white women , or t-score of -2.5 .
In other words Osteoporosis is defined as “a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequent increase in fracture risk .
Vitiation of Asthi Dhatu : It causes Asthi toda ; Sandhi shaithilya ; Danta , Nakha , Kesha rukshata / patana; Vivarnata ; Adhyasthi danta , Danta asthibheda .
Recent advances in the study of Osteoporosis have shown that the deformity in the nail and teeth is a definite indication of risk of Osteoporosis . It also supports an association of Osteoporosis with the onset and progression of periodontal disease in humans . Brittle nails are also indication of Osteoporosis .
During Menopause , there is decline in all the dhatus and increase in Vata . In women Oestrogen depletion accelerates bone loss .
Ayurvedic Management :
Niadana Parivarjana : Factors aggravating Osteoporosis should be avoided eg smoking , aerated drinks , high protein intake , obesity , sedentary lifestyle etc .
Diet : During menopausal phase of life ,diet rich in calcium and phytoestrogens should be taken .
Formulations : Ayurvedic preparations are helpful in osteoporosis and maintaining bone health and should be taken under supervision .
Bone loss accelerates at menopause , making women over 50 particularly susceptible to the potentially devastating effects of osteoporosis and fracture . No matter what your age , strategies for prevention should include a combination of targeted exercise ; bone health nutrition ; avoidance of negative lifestyle factors and early identification of individual factors .