As Dr Kanwarjit Kocchar, a gynaecologist, explains: ``In women, menopause and osteoporosis are directly proportionate to one another. It would not be wrong to say that one out of every two women suffers from osteoporosis after menopause. The depletion of estrogen resulting due to menopause can lead to osteoporosis and eventually to fractures, coronary heart disease, Alzheimer's disease and dementia causing depression and an inability to think and make decisions.'' It can also lead to a hump, chronic pain and disability. Osteoporosis is caused due to a reduction in bone mass with the advancement of age. Peak bone mass occurs between 20 and 30 years of age. After 30, the bone mass gradually decreases. In women, after menopause, the bone mass shrinks even faster. As Dr Kocchar describes, ``in most cases, there are no symptoms at all; it progresses painlessly until the bones become so brittle that routine activities like coughing and sneezing can cause a fracture.''

When the spine is affected, a simple action like bending or making the bed can be enough to cause a `crush fracture'.

Osteoporosis cannot be diagnosed through an X-ray. But tests like bone densitometry are available that are used to diagnose it at an early stage so that further progression can be halted. Hormone Replacement Therapy (HRT) is the most commonly used treatment to halt the disease. However, it would be useful to remember that osteoporosis is responsible for the highest rate of morbidity and mortality 25 per cent of the patients die within 12 months and at least 50 per cent are eventually unable to even walk independently. A healthy, active life, say doctors, is the best way to keep this disease away.