Pregnancy and Lactation-associated Osteoporosis (PLO)

What is pregnancy and lactation-associated osteoporosis (PLO)?

Pregnancy and lactation-associated osteoporosis (PLO) is a rare form of osteoporosis that typically occurs during the third trimester or postpartum. It is relatively rare, occurring in 0.4 in every 100,000 pregnancies.

Osteoporosis is a condition in which the bones become weak and brittle. It is fairly common among adults aged 50 and over, but can affect younger people as well. In fact, when it is associated with pregnancy and lactation, as in PLO, it tends to be more severe, with more fractures and a higher prevalence of multiple fractures.

What are the risk factors for PLO?

The following factors increase the risk for PLO:

  • Breastfeeding
  • Twin pregnancies
  • Lower BMI
  • First degree relatives with PLO
  • Physical inactivity
  • Poor nutrition
  • Insufficient calcium intake
  • Smoking

What are the symptoms of Pregnancy and Lactation-associated Osteoporosis (PLO)?
  • Severe low back pain
  • Hip pain
  • Height decrease
  • Vertebrae fractures

What is the treatment for Pregnancy and Lactation-associated Osteoporosis (PLO)?

Treatment includes calcium and vitamin D supplements. If the mother is breastfeeding, it is usually advised to stop breastfeeding. For pain management, analgesics (pain relieving drugs like acetaminophen and ibuprofen) and physical therapy are recommended. Physical therapy may include transcutaneous electrical nerve stimulation, hot-pack application, postural and muscle strengthening exercises, and thoracolumbar corset.

There may be some correlation to postpartum depression, due to the resulting pain and inability to care for the baby. In these cases, treatment may also include psychotherapy.

Who can help diagnose/treat Pregnancy and Lactation-associated Osteoporosis (PLO)?
  • OB/Gyn
  • Primary Care Physician (PCP)
  • Physical Therapist (PT)