Osteoporosis causes changes to your bone’s structure that weaken its density and quality. This makes your bones more fragile, and likely to fracture or break.

Routine screenings using special imaging technology can help identify osteoporosis and allow you to take preventive measures. The timing for these screenings depends on certain risk factors, including gender and age.

Healthcare professionals call osteoporosis a “silent” condition because you often don’t know you have it until you break a bone or notice worsening posture.

Here’s what you need to know about osteoporosis, screening for it, and preventing it.

By the numbers

A 2014 study looked at data from the 2005 to 2010 National Health and Nutrition Examination Survey and the 2010 U.S. Census.

Key insights into the prevalence of osteoporosis in the United States include:

  • An estimated 10 million U.S. adults have osteoporosis.
  • The condition affects women more than men. About 20 percent of women and 5 percent of men over 50 years old have osteoporosis.
  • An additional 43 million Americans were estimated to have low bone mass, also called osteopenia. This means bones aren’t as healthy and strong as they should be. Having osteopenia doesn’t necessarily mean you’ll develop osteoporosis, but it’s still a good idea to take preventive measures.
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The U.S. Preventive Services Task Force makes recommendations as to when individuals may need key health screenings, including for osteoporosis. They recommend osteoporosis screenings for women ages 65 and older, but they don’t make specific recommendations for men.

Experts recommend osteoporosis screenings for men and women who have certain risk factors associated with the condition.

According to 2021 research, examples of these risk factors include:

  • history of previous bone fractures
  • history of taking certain medications, such as prednisone or chronic heparin
  • having a medical condition that increases your risk of bone fractures, such as Cushing’s syndrome or chronic renal failure
  • low body mass
  • family history of osteoporosis or other bone-related disorders, especially a history of maternal hip fracture before 50 years old
  • lifestyle habits that could affect bone health, such as excess alcohol use or smoking

A doctor will also consider recent changes to your height and posture that could be due to underlying osteoporosis.

It’s important to share your health history, medications taken, and any changes to your health you may have noticed when you talk to your doctor. Doing so can help your doctor identify if you could benefit from an osteoporosis screening.

Experts make these recommendations based on your sex and gender assigned at birth. But sex and gender are not the same. Both exist on a spectrum, and your sex assigned at birth does not determine your gender.

Transgender people can also be at risk of osteoporosis. Hormone therapy and certain surgeries which affect hormone production may change your risk factors. It’s important to talk with your doctor and put together the best plan for your individual health.

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There are different imaging approaches for osteoporosis screening. Dual energy X-ray absorptiometry (DXA or DEXA) is the most common.

A DEXA scan is a noninvasive test that involves passing an X-ray scanner over your body, usually as you are lying down. The X-rays are low dose, according to 2021 research, which means they have very low radiation levels. DEXA uses two X-ray beams to target both soft tissue and bone, creating a fuller picture of bone health. The whole process takes a few minutes.

DEXA is often directed at the hips and spine, areas prone to fractures. You may be asked to change positions during the scan for better images.

Because the test is noninvasive and involves a very low radiation dose, most people can safely get a DEXA scan. However, notify the technician or doctor if you are pregnant or have hardware or other medical implant devices in the areas to be scanned.

There are other ways to diagnose osteoporosis, but they are usually not as effective as DEXA.

  • Peripheral DEXA. This is a scan similar to DEXA that scans the hips and spine. However, the peripheral DEXA is a portable machine that can measure bone density in only small areas, such as the wrist and heel. These may help a doctor estimate treatment effectiveness.
  • Quantitative ultrasound. This imaging study involves using an ultrasound machine, with no radiation, to evaluate the bone in your heel. However, this ultrasound doesn’t measure density. Instead, it estimates bone loss.
  • X-rays. These scans can reveal bone fractures and breaks which may be caused by osteoporosis. But traditional X-rays cannot identify the condition on their own.

An online tool called FRAX can also be used to evaluate your 10-year possibility of osteoporosis-related bone fractures. FRAX is an algorithm that identifies an individual’s risk factors through a 12-point questionnaire, and responds with a score. FRAX cannot diagnose osteoporosis, but can help you see if further screening or lifestyle changes are advisable.

Osteoporosis management depends on what a healthcare professional sees following a DEXA scan.

Lifestyle changes

Doctors will usually recommend lifestyle changes first if they detect mild bone loss, or osteopenia.

The goal of these changes is to help strengthen your muscles and bones. These changes are also meant to prevent injuries and long-term complications which can occur if osteoporosis develops.

According to a 2018 review, examples of these suggestions include:

  • getting an adequate calcium intake, which is usually about 1,000 milligrams per day for men ages 50 to 70 and 1,200 milligrams per day for women ages 51 and older
  • getting an adequate vitamin D intake
  • preventing falls, which you can do by placing nonskid devices in the bathtub and on floors
  • performing regular weight-bearing exercises, like lifting weights, walking, jogging, and other activities
  • limiting alcohol and caffeine consumption
  • quitting smoking, if you smoke


If your doctor detects osteoporosis on your DEXA scan, they will discuss medical management of your condition.

Healthcare professionals may prescribe medications designed to treat osteoporosis. These can include hormone-related therapies.

There are two main categories of medications to treat osteoporosis.

Antiresorptive medications

Antiresorptive medications lower the rate at which bone is resorbed, or broken down, by the body. This class of medications includes bisphosphonates and selective estrogen receptor modulators (SERMs).

Bisphosphonates are some of the most commonly prescribed medications to treat osteoporosis. Bisphosphonates like alendronate and risedronate work to slow bone loss.

SERMs target specific estrogen receptors and can mimic the hormone estrogen’s positive effects on bone density. They are most often prescribed to people in postmenopause. Common SERMs include tamoxifen and raloxifene.

Doctors do not consider SERMs the first-line treatment approach for most people with osteoporosis. Overall, these medications are not as effective as bisphosphonates or anabolics.

However, if you are at high risk of fracture, a doctor may prescribe medications such as teriparatide, denosumab, or zoledronic acid. These medications are given via injection or intravenously (IV).

Anabolic medications

Anabolic medications help increase the formation of bone and lower the incidence of fractures. According to a 2018 review, teriparatide and abaloparatide are the only anabolic medications approved by the Food and Drug Administration (FDA) for osteoporosis.

There are two osteoporosis types.

Primary osteoporosis is usually due to the effects of aging, according to a 2018 review, including reductions in the hormones estrogen and testosterone.

Secondary osteoporosis is related to medical conditions and medications. Glucocorticoids such as prednisone are the most common medications that cause secondary osteoporosis. Those with rheumatoid arthritis commonly take this medication.

Both osteoporosis types have preventable aspects.

To prevent osteoporosis, you can:

  • Engage in regular physical activity. A 2020 review looked at studies related to exercise in osteoporosis prevention. The researchers found that engaging in multiple exercise types and different resistance training forms was most effective. Those who exercised at least 2 to 3 times per week for 60 minutes or more experienced the greatest increases in bone health.
  • Refrain from smoking.
  • Refrain from excess alcohol intake.
  • Eat a nutritious diet high in fruits, vegetables, and low fat calcium sources. Consult your doctor or a dietitian before making sweeping changes to your diet.
  • Talk with your doctor about the medications you take. Taking the lowest dosages for the least amount of time recommended can help you preserve your bone health.

Many osteoporosis prevention techniques are also beneficial for your overall wellness. These lifestyle adjustments can have a positive impact on your mood, sleeping patterns, and more.

Osteoporosis causes bone mass and density loss, and can lead to repeated fractures. It can be brought on by age or genetic factors, as well as by certain medications and other health conditions.

Screenings are recommended for women 65 years and older, or women over 50 years old with certain risk factors. Men have a lower incidence of osteoporosis, but they still experience it. You can also have low bone mass without having osteoporosis.

Getting enough calcium in your diet, exercising regularly, and limiting substance use can help prevent the disease from developing or worsening. If you have osteoporosis, prescription medications can treat symptoms and improve bone health.

The DEXA imaging technique is the most accurate diagnostic tool. Screening for osteoporosis can help prevent complications that can affect your mobility and quality of life. Talk with your doctor about your osteoporosis risks and the best time to start screenings.