Definition

Osteoporosis is a disease that reduces bone mass, bone density, and bone quality. It makes bones weak and brittle. Osteoporosis can lead to broken bones. Breaks in the hip, spine, and wrist are common but breaks can happen anywhere.

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Causes

Osteoporosis happens when bone loss happens faster than bone growth. The cycle of bone loss and growth is normal throughout life. However, bone loss happens faster after age 30. There are many other things over a lifetime that increase the chance of osteoporosis.

Risk Factors

Osteoporosis is more common in older adults and women. It’s also more likely to happen if full bone mass was not reached in childhood or early adult years.

The risk of osteoporosis is also higher if you have 1 or more of the following:

• Low body weight
• Smoking
• Alcohol use disorder
• A history of falls
• A family history of osteoporosis
• Being in menopause
• Regular use of some medicine, such as long term use of blood thinners or stomach acid reducers
• Low estrogen levels in women or low testosterone levels in men
• Inactivity
• Certain diets that can result in a lack of calcium or vitamin D
• Too little sunlight—sun on the skin is a main source of vitamin D
• Certain cancers such as lymphoma and multiple myeloma

Some health conditions also increase the risk of osteoporosis:

• Rheumatoid arthritis
• No menstrual periods— amenorrhea
• Hyperthyroidism
• Type 2 diabetes
• Asthma
• Liver disease
• Eating disorders
• Depression
• Crohn disease
• Celiac disease
• Female athlete triad

Symptoms

Many do not know they have osteoporosis until a bone breaks. Other symptoms that may appear are:

• Severe back pain
• Loss of height with stooped posture— kyphosis

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Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Blood and urine tests may be done to rule out other problems such as a hormone imbalance. Images bones may be taken with:

• Dual-energy x-ray absorptiometry (DXA)
• Quantitative ultrasound (QUS)
• Quantitative CT scan (QCT)

Treatment

The goal of treatment is to lower the chance of breaks and slow more bone loss. Both lifestyle changes and medicine can help.

Prevention

It is important to build strong bones throughout childhood and early adult years. This will build a better bone supply for later years.

Other ways to decrease the risk of osteoporosis include:

• Eat a balanced diet rich in calcium and vitamin D.
• Perform weight-bearing exercises.
• Live a healthy lifestyle—avoid smoking and drink alcohol only in moderation (2 drinks or less a day for men, 1 drink or less a day for women).
• Talk to your doctor about risk for osteoporosis if you have gone through menopause. Medicine may help to prevent osteoporosis.