Osteoporosis

Osteoporosis is a bone density condition that is a leading cause of hip fractures in older people, although it can affect people of all ages, including children.

What is osteoporosis?

Osteoporosis is a metabolic bone disorder in which bone tissue breaks down, causing low bone density. This makes the bone increasingly fragile and prone to fractures. Osteoporosis is a “silent disease,” since there are no warning signs or symptoms until bone fractures occur. In the United States alone, an estimated 1.5 million bone fractures each year are attributed to low bone density.

Who gets osteoporosis?

Osteoporosis and osteopenia (a less severe form of low bone density) can affect people of all ages but becomes more likely as we age. Women, especially post-menopausal women, have the greatest risk, accounting for about 80% of all cases. A rare but severe form of the disease known as pregnancy and lactation-associated osteoporosis (PLO) affects younger women, usually in the third trimester of pregnancy or during lactation. In these cases, women usually develop multiple vertebral fractures in the spine.

Animation on osteoporosis of the spine

What causes osteoporosis?

Bone loss in adolescence and early adulthood can be a result of a failure to attain peak bone mineral density, and accelerated bone loss may be particularly noted around menopause and in later years. Many factors, including diet (in particular, insufficient levels of calcium and vitamin D intake) and the lack of proper exercise, contribute to bone loss during these periods.

It can also occur as a result of numerous underlying conditions, many of which are often not readily apparent during the course of a doctor visit. Therefore, laboratory testing, including serum and urine studies, is helpful in determining possible secondary causes.

How do you prevent osteoporosis?

Many studies have shown that calcium and vitamin D is an essential nutrient for bone health. The amount of calcium that individuals need varies, but adults typically require about 1,200 to 1,500 milligrams daily. It is especially important that growing teenage girls to get adequate calcium in their diets, in order to prevent osteoporosis later in age. Every day, approximately 10,000 milligrams of calcium move in and out of the skeleton to renew and repair the bone. Food remains the best source of calcium, but some people may need to get additional calcium by taking supplements.

Also crucial for good bone health is:

• exercise – weight bearing and resistance exercises help build bone and maintain healthy bone
• fall prevention – good balance and removing potential dangers around the house
• maintaining a healthy weight
• quitting or avoiding smoking tobacco
• limit alcohol intake – two drinks a day increases the risk of fracture

How is osteoporosis diagnosed?

A dual-energy X-ray absorptiometry (DXA  or "DEXA") bone mineral density test will help your doctor determine whether or not you have osteoporosis. In addition, a blood and urine test will rule out underlying conditions and medical concerns.

How is osteoporosis treated?

Along with continuing the lifestyle involved in preventing osteoporosis such as healthy eating, calcium and vitamin D supplements and limiting risky behavior, your doctor might suggest special medications to increase bone mineral density. The most important goal is to lower risk of fracture. If needed, your doctor will explain the risks and benefits of the various medications offered and work with you on deciding what's best.

For more information, contact the Osteoporosis and Metabolic Bone Health Center at HSS, which was founded to help prevent and treat osteoporosis, and explore the articles below.

Updated: 6/16/2022

Reviewed and updated by Alana C. Serota, MD, CCFP, CCD