Osteoporosis

Understanding Osteoporosis: What It Means for Your Bones

Osteoporosis is a common condition—especially among older adults—that causes bones to become weak and more likely to break. It happens when your body loses too much bone, doesn’t make enough new bone, or both.

This guide explains how bones naturally change over time, what can lead to osteoporosis, and how the condition is diagnosed and treated.

How Do Bones Become Weaker?

You may not think of bones as active organs, but they are. Your bones are constantly remodeling—breaking down old tissue and replacing it with new. This process has two main phases:

  • Bone resorption: Specialized cells called osteoclasts break down bone tissue, releasing minerals into the bloodstream.

  • Bone formation: Another group of cells, osteoblasts, fill in the gaps with fresh bone tissue.

In healthy bones, this cycle stays in balance. But with osteoporosis, more bone is broken down than rebuilt, leading to less dense, more fragile bones.

What Causes Osteoporosis?

Several factors can disrupt the bone remodeling balance, including:

  • Aging

  • Hormonal changes (especially after menopause)

  • Lack of physical activity

  • Certain medications

  • A diet low in calcium or vitamin D

  • Chronic diseases affecting bone health

How Is Osteoporosis Diagnosed?

Doctors use a combination of your medical history, physical exam, and a bone density test to evaluate your bone health. The most common test is the central DXA scan—a specialized X-ray that measures bone density in your hip and spine.

A DXA scan can:

  • Detect osteoporosis before a fracture occurs

  • Estimate your risk of future fractures

  • Monitor changes in bone density over time

  • Help determine whether a fracture was caused by bone loss

According to national guidelines, a DXA scan is recommended for:

  • Women age 65 and older

  • Men age 70 and older

  • Anyone over age 50 with a fracture

  • Postmenopausal women and men age 50–69 with risk factors

  • People with back pain or noticeable loss of height

Your doctor will guide you on when and how often testing should be done.

Treatment Options

Osteoporosis is treated with medications that help restore balance to the bone remodeling process. These treatments work by:

  • Slowing bone breakdown

  • Increasing bone formation

Your provider will choose the best option based on your test results, health history, and preferences. Some medications come as pills, while others are given by injection or infusion.

The goal of treatment is to strengthen bones, reduce the risk of fractures, and support long-term health.

✅ Osteoporosis Treatment Checklist

Initial Steps:

  • [ ] Review your bone mineral density (DXA) scan results with your healthcare provider

  • [ ] Confirm diagnosis and risk category (osteopenia vs. osteoporosis)

  • [ ] Identify personal risk factors (e.g., age, family history, fractures, medication use)

  • [ ] Discuss treatment goals: prevent fractures, improve bone strength, slow progression

Medication Plan:

  • [ ] Begin prescribed osteoporosis medication (e.g., bisphosphonates, denosumab, teriparatide, romosozumab)

  • [ ] Understand how and when to take your medication (some require fasting, specific posture, or timing)

  • [ ] Stay on schedule—set reminders if needed for weekly/monthly/quarterly dosing

  • [ ] Watch for and report side effects such as gastrointestinal discomfort or jaw pain

  • [ ] Refill prescriptions before running out

Lifestyle & Bone Health Support:

  • [ ] Follow a calcium-rich diet with plenty of leafy greens, low-fat dairy, or fortified foods

  • [ ] Ensure adequate vitamin D through safe sun exposure or supplements

  • [ ] Engage in weight-bearing and resistance exercises regularly (walking, yoga, gentle strength training)

  • [ ] Avoid smoking and limit alcohol consumption

  • [ ] Fall-proof your home—secure rugs, improve lighting, and use assistive devices if needed

Ongoing Monitoring:

  • [ ] Schedule follow-up bone density scans as recommended (typically every 1–2 years)

  • [ ] Track any new fractures or height loss and report them to your doctor

  • [ ] Reassess treatment effectiveness and adjust medications if needed

  • [ ] Discuss dental health before receiving certain osteoporosis treatments

Sources

  • National Osteoporosis Foundation website, www.nof.org. Accessed December 3, 2018.