Osteoporosis

Osteoporosis is a condition that causes your bones to be thinner and weaker than normal. This means, they can break easily, such as after a small bump or fall.

  • Osteoporosis affects more than half of women and about one-third of men over 60 years, as well as a few younger people.
  • There are good treatments that can slow the progression of osteoporosis and help to stop you getting broken bones.
  • Osteoporosis can be prevented by strengthening your bones. This can be achieved by keeping physically active, getting enough vitamin D and calcium in your diet and not smoking. 

What are the symptoms of osteoporosis?

One of the challenges with osteoporosis is there are no early warning symptoms or signs. First signs can include:

  • A fracture of the wrist, hips, spine or other bones that happens more easily than it should
  • Loss of height – as the vertebrae of the spine weaken they compress and the spine curves.
  • With more severe osteoporosis, fractures can occur doing routine things like bending, lifting or just getting up from a chair.
  • This happens because brittle bones have trouble supporting body weight.

How is osteoporosis diagnosed?

Your doctor can assess your risk for osteoporosis from your medical history and by asking you about your lifestyle. Physical signs that you may have weak bones include:

  • previous fractures (often of the wrist, hip or spine)
  • a loss of height or stooping
  • a curved spine.

Your doctor may suggest you have a bone density scan (also called DEXA scan) to check for bone weakness.

How is osteoporosis treated?

Treatment for osteoporosis will depend upon the results of bone density scans, age, gender, medical history and the severity of the condition. Treatment most commonly involves lifestyle changes and medications and aims to increase bone density and reduce the risk of bone fracture.

Treatment options include:

  • Calcium and vitamin D supplementation
  • An exercise programme including strength training exercises, weight-bearing aerobic activities and/or flexibility exercises.
  • Medications such as:

Read more about treatment for osteoporosis.

Decision aids – choosing the right medication

The following decision aids are a helpful tool to use with your doctor to discuss the pros and cons of treatment.

See also: Risk of bone fracture WHO

Can osteoporosis be prevented?

Some people are more likely to get osteoporosis than others. Some of the risk factors that increase your likelihood of getting osteoporosis can't be changed, such as your sex or age, but many others can (see: risk factors you can change).

Risk factors you cannot change include:

  • being female – although men can also develop osteoporosis
  • increasing age - bones get thinner as we age
  • family history of osteoporosis or fractures
  • being very thin and unable to put on weight
  • long-term use of some medications ie, prednisone, depo provera
  • in women, irregular periods or early menopause (often caused by having your ovaries removed)
  • being immobilised in bed for long periods.

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Risk factors you can change

Being aware of the risk factors you can change means that you can take steps to keep your bones healthy and strong, which will reduce the chance of osteoporosis developing.

Risk factors you can change Preventative action
Smoking
Diet low in calcium
  • The best sources of calcium are low-fat milk and milk products as the calcium in milk is easily absorbed by the body.
  • Aim for 4 servings of low-fat dairy products a day.
  • Read more about calcium.
Low vitamin D levels
  • Vitamin D helps increase the absorption of calcium in food and optimises bone health and muscle function.
  • As little as 15 minutes under the sun (without sunscreen), three times a week enables your body to manufacture enough vitamin D – but you need to be sensible.
  • Exposing your skin to the sun increases your risks of skin cancer and it’s important that you should never get sunburnt. Read more about sensible sun exposure.
Being physically inactive or doing non-weight bearing exercise only
  • Aim to be physically active every day.
  • Include a range of strength training exercises, weight-bearing aerobic activities and flexibility exercises.
  • Read more about physical activity.
Diet high in salt
  • Try to reduce the amount of salt in your diet by eating fresh foods without adding salt and limiting packaged or processed foods.
  • See tips for lowering salt.
Excessive alcohol
  • If you drink alcohol, aim to keep your drinking within the recommended weekly allowance (no more than 10 standard drinks a week in women and 15 standard drinks a week in men). 
  • Read more about alcohol.

Read more on how to prevent osteoporosis.

Falls prevention

  • A fall at any age can be dangerous, but falls become increasingly common and far more likely to cause injury after the age of 55 years.
  • If you have osteoporosis, you are more likely to break a bone if you fall, and if you break a bone, you might need a long time to recover.
  • Learning how to prevent falls can help you avoid broken bones and the problems they can cause.
  • Read more about falls prevention.

Learn more

Preventing osteoporosis booklet Ministry of Health NZ, 2006 
Osteoporosis and fractures Osteoporosis NZ
Osteoporosis NHS Choices UK, 2014
Osteoporosis section Medline Plus and National Institutes of Health USA, 2014
How dense are you? Osteoporosis Australia Medical & Scientific Advisory Committee, 2014
Family health history Learn Genetics (Genetic Science Learning Centre), University of Utah, USA, 2015

Credits: Editorial team. Reviewed By: Dr Ben Darlow, senior lecturer and researcher, Department of Primary Health Care and General Practice, University of Otago, Wellington Last reviewed: 09 Aug 2018