Osteoporosis is the most common bone disease in adults. However, it usually occurs in people over 50. It’s rare for osteoporosis to occur during pregnancy.

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When osteoporosis happens during pregnancy, it’s called pregnancy-associated osteoporosis (PAO). The symptoms are usually back pain and broken bones. Though extremely rare, it can cause significant pain and lead to lasting injury.

Learn more about osteoporosis.

Only about 2% of people with osteoporosis are under 50, and only 1.2% are between ages 20 and 40 years. So few people have PAO that researchers are unsure of the exact number.

It’s also possible, but rare, to develop osteoporosis following delivery while nursing. If this happens, it’s known as pregnancy and lactation-associated osteoporosis (PLO).

PAO causes bones, most often vertebrae and sometimes the hip, to become thinner and weaker. In osteoporosis, the internal structure of the bone becomes thinner and weaker. Because PAO is so rare, it’s not something that is routinely screened for, and the first signs are usually back pain or a broken bone.

Osteoporosis during pregnancy is rare and usually unexpected. The early symptoms may be subtle, and there may not be symptoms until a bone breaks.

Symptoms of osteoporosis during pregnancy may include:

Yes, you can get pregnant if you have osteoporosis.

If you know you already have osteoporosis, depending on the cause of your osteoporosis, your doctor may treat you before you become pregnant. Or you may need to stop treatment for another condition if that treatment is causing the osteoporosis.

For example, the common form of osteoporosis caused by another condition is glucocorticoid-induced osteoporosis (GIOP). This type of osteoporosis affects about 20% of all people with osteoporosis.

Most people who have GIOP have another condition or disease, such as:

These conditions are treated with glucocorticoid steroids, which can cause bones to be reabsorbed and weakened, leading to osteoporosis.

Researchers are unsure why osteoporosis may happen during pregnancy. If you had osteoporosis before your pregnancy, there may be several causes, including:

Though researchers are unsure why, there seem to be risk factors for having osteoporosis during pregnancy. These risk factors may include:

It’s essential to follow your doctor’s instructions if you have osteoporosis during pregnancy. The main goals of treatment for osteoporosis are to relieve your pain, prevent further broken bones, and begin to restore bone density. There are several treatment options that won’t affect the baby, including:

  • medications that help increase bone density, such as:
    • Calcitonin
  • surgery to repair vertebral fractures, such as kyphoplasty and vertebroplasty

Bisphosphonates are common medications often prescribed to help people with osteoporosis. Because they can affect the development of a baby’s skeleton, urinary tract anomalies, and face, they are not prescribed during pregnancy.

Bisphosphonates may remain in your bones for up to 10 years, so there’s also a possibility that they might affect future pregnancies as well.

Few people experience osteoporosis during pregnancy. However, for those who do, it may be painful and stressful. Though the condition usually does not affect the baby, people with osteoporosis during pregnancy may need treatment following pregnancy. Also, and it may limit their ability to nurse the baby depending on the severity of loss of bone density.

For individuals who have osteoporosis during pregnancy, it’s important to discuss plans for another pregnancy when creating a treatment plan to avoid medications that might impact future pregnancies.

There are no specific guidelines for the treatment of osteoporosis during pregnancy, but treatment may continue for 13 months to 5 years.

Individuals with severe back pain during pregnancy may be evaluated for PAO. Imaging tests are generally performed to evaluate bones.

Tests that may be done during pregnancy include:

Tests that may be done after delivery include:

What Does It Mean If You Have Osteoporosis During Pregnancy?

It’s vital to get enough calcium and vitamin D during pregnancy.

The American College of Obstetricians and Gynecologists (ACOG) recommends 600 international units (Iu) of vitamin D and 1,300 milligrams (mg) of calcium if you are 14 to 18 years or 1,000 mg of calcium if you are 19 to 50 years old.

You can meet some of these recommendations by taking a prenatal vitamin, getting outside in the sunshine for vitamin D, and eating foods like:

  • fortified milk
  • cheese
  • yogurt
  • dark green leafy vegetables
  • fatty fish such as salmon and sardines

Calcium is supposed to be good for your bones, but can you take too much calcium?

Yes, you can take too much calcium.

When you have too much calcium, the excess is eliminated in your urine through your kidneys. In some people, this can lead to kidney stones. It’s best to get your calcium from calcium-rich foods like dairy, green leafy vegetables, and fatty fish.

PAO is extremely rare, but it can happen. The first symptoms may be broken bones or severe back pain. Treatment may last for months to years.

Individuals with PAO will need to be monitored in future pregnancies and may need to avoid nursing the baby.