General Health

Osteoporosis

Osteoporosis is a condition that weakens bones, making them fragile and more likely to break. It is common with aging, especially in women after menopause.

4 min read

Intro

Osteoporosis is a disease that weakens bones, making them fragile and more likely to break.
Often called a “silent disease,” it usually shows no symptoms until a fracture occurs.
It affects millions worldwide and is a major cause of disability in older adults.

Key Points

  • Osteoporosis = reduced bone density and fragile structure.
  • Most common in women after menopause, but also affects men.
  • Often detected only after a fracture.
  • Diagnosed with bone density scans (DEXA).
  • Treatments reduce bone loss and fracture risk; lifestyle measures help prevent progression.

Signs and Symptoms

  • Usually no symptoms until a fracture occurs.
  • Common fracture sites: hip, spine, wrist.
  • Spine fractures may cause height loss, stooped posture, or back pain.
  • Hip fractures often lead to loss of mobility and independence.

Causes and Risk Factors

  • Hormonal changes: estrogen loss after menopause, low testosterone in men.
  • Aging: bone remodeling slows with age.
  • Family history: higher risk if a parent had fractures.
  • Lifestyle: smoking, alcohol, inactivity, poor diet.
  • Medical conditions: rheumatoid arthritis, cancer, thyroid disease.
  • Medications: long-term steroids (glucocorticoids).

Diagnosis

  • Bone density scan (DEXA): the gold standard test.
    • T-score –1.0 to –2.5 = osteopenia (low bone mass).
    • T-score ≤ –2.5 = osteoporosis.
  • Fracture history: low-impact fractures raise suspicion.
  • Blood tests: may be done to rule out other causes.

Treatment

Lifestyle and prevention:

  • Weight-bearing exercise: walking, stair climbing, dancing.
  • Resistance training: improves bone strength and muscle support.
  • Balance and flexibility training: tai chi, yoga — reduce fall risk.
  • Adequate calcium and vitamin D intake.
  • Avoid smoking and limit alcohol.
  • Home safety measures to prevent falls.

Medications:

  • Bisphosphonates (alendronate, risedronate, zoledronic acid): most common first-line therapy.
  • Denosumab: injection given every 6 months.
  • Hormone-related therapies: estrogen therapy or SERMs for some women.
  • Anabolic drugs: teriparatide and romosozumab may be used in severe cases to build bone.

Risks and Prognosis

  • Fracture risk rises sharply with untreated osteoporosis.
  • Hip and spine fractures carry the greatest risk of disability and death.
  • With treatment, bone loss can be slowed, fracture risk reduced, and quality of life maintained.

FAQ

Q: Who should get screened?
A: Women over 65, men over 70, and younger people with risk factors or prior fractures.

Q: Can osteoporosis be reversed?
A: Bone density can be improved with some treatments, but full reversal is uncommon. The main goal is reducing fracture risk.

Q: Is it only a women’s disease?
A: No — men are also affected, particularly with age or certain medical conditions.

Q: What’s the difference between osteoporosis and osteopenia?
A: Osteopenia is “low bone mass” (mild bone loss). Osteoporosis is more severe and carries a higher fracture risk.

Further Reading