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What is osteoporosis?

Osteoporosis is a disease that weakens your bones. It makes your bones thinner and less dense than they should be. People with osteoporosis are much more likely to experience broken bones (bone fractures).

Your bones are usually dense and strong enough to support your weight and absorb most kinds of impacts. As you age, your bones naturally lose some of their density and their ability to regrow (remodel) themselves. If you have osteoporosis your bones are much more fragile than they should be, and are much weaker.

Most people don’t know they have osteoporosis until it causes them to break a bone. Osteoporosis can make any of your bones more likely to break, but the most commonly affected bones include your:

The sooner a healthcare provider diagnoses osteoporosis, the less likely you are to experience bone fractures. Ask a healthcare provider about checking your bone density, especially if you’re over 65, have had a bone fracture after age 50, or someone in your biological family has osteoporosis.

How common is osteoporosis?

More than 50 million people in the U.S. live with osteoporosis.

Osteoporosis is common in people over 50. Experts estimate that half of all people assigned female at birth and 1 in 4 people assigned male at birth over 50 have osteoporosis.

Studies have found that 1 in 3 adults over 50 who don’t have osteoporosis yet have some degree of reduced bone density (osteopenia). People with osteopenia have early signs of osteoporosis. If it’s not treated, osteopenia can become osteoporosis.

Symptoms and Causes

What are osteoporosis symptoms?

Osteoporosis doesn’t have symptoms the way lots of other health conditions do. That’s why healthcare providers sometimes call it a silent disease.

You won’t feel or notice anything that signals you might have osteoporosis. You won’t have a headache, fever or stomachache that lets you know something in your body is wrong.

The most common “symptom” is suddenly breaking a bone, especially after a small fall or minor accident that usually wouldn’t hurt you.

Even though osteoporosis doesn’t directly cause symptoms, you might notice a few changes in your body that can mean your bones are losing strength or density. These warning signs of osteoporosis can include:

  • Losing an inch or more of your height.
  • Changes in your natural posture (stooping or bending forward more).
  • Shortness of breath (if disks in your spine are compressed enough to reduce your lung capacity).
  • Lower back pain (pain in your lumbar spine).

It might be hard to notice changes in your own physical appearance. A loved one may be more likely to see changes in your body (especially your height or posture). People sometimes joke about older adults “shrinking” as they age, but this can be a sign that you should visit a healthcare provider for a bone density test.

What causes osteoporosis?

Osteoporosis happens as you get older and your bones lose their ability to regrow and reform themselves.

Your bones are living tissue like any other part of your body. It might not seem like it, but they’re constantly replacing their own cells and tissue throughout your life. Up until about age 30, your body naturally builds more bone than you lose. After age 35, bone breakdown happens faster than your body can replace it, which causes a gradual loss of bone mass.

If you have osteoporosis, you lose bone mass at a greater rate. People in postmenopause lose bone mass even faster.

Osteoporosis risk factors

Anyone can develop osteoporosis. Some groups of people are more likely to experience it, including:

  • Anyone over 50.
  • People assigned female at birth (AFAB), especially people AFAB in postmenopause.
  • People with a family history (if someone in your biological family has osteoporosis).
  • People who are naturally thin or who have “smaller frames.” People with thinner statures often have less natural bone mass, so any losses can affect them more.
  • People who smoke or use tobacco products.

Some health conditions can make you more likely to develop osteoporosis, including:

Some medications or surgical procedures can increase your risk of osteoporosis:

Certain aspects of your diet and exercise routine can make you more likely to develop osteoporosis, including:

  • Not getting enough calcium or vitamin D in your diet.
  • Not getting enough physical exercise.
  • Regularly drinking alcohol (more than two drinks per day).

Diagnosis and Tests

How is osteoporosis diagnosed?

A healthcare provider will diagnose osteoporosis with a bone density test. A bone density test is an imaging test that measures the strength of your bones. It uses X-rays to measure how much calcium and other minerals are in your bones.

Healthcare providers sometimes refer to bone density tests as DEXA scans, DXA scans or bone density scans. All of these are different names that refer to the same test.

A bone density test uses low levels of X-rays to measure the density and mineral content of your bones. It’s similar to a typical X-ray. It’s an outpatient procedure, which means you won’t have to stay in the hospital. You can go home as soon as you finish your test. There are no needles or injections in this test.

Checking for changes in your bone density is the best way to catch osteoporosis before it causes a bone fracture. Your provider might suggest you get regular bone density tests if you have a family history of osteoporosis, if you’re over 50, or you have osteopenia.