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Osteoporosis Guide

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Osteoporosis is a disease that weakens the bones. Weakened bones are more likely to break (fracture). Osteoporosis can affect anyone. But those most at risk are postmenopausal people who were assigned female at birth. To help prevent osteoporosis, you need to exercise and nourish your bones throughout your life.

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You might want to talk to your doctor about osteoporosis if you went through early menopause. Or if you took corticosteroids for several months at a time, or if either of your parents had hip fractures.

The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures. Your health care provider may recommend:

  • Proper nutrition
  • Lifestyle changes
  • Exercise
  • Fall prevention to help prevent fractures
  • Medications

Bone density testing: Bone density testing is safe, quick, easy and painless. It can find osteoporosis before a fracture happens. It can also measure how well treatment works. There are several types of tests that you may have. They include:

Central tests: These are used for screening and diagnosis. They measure density in the hip and spine. The main central test is the dual energy X-ray absorptiometry (DEXA). The DEXA scan is the standard bone density test.

Peripheral tests: These are used for screening. They measure density in the finger, wrist, knee, shin, or heel. A common peripheral test is the quantitative ultrasound (QUS). But QUS screening is not as accurate as DEXA scans. 

Who should be tested?

  • All postmenopausal women under age 65, with 1 or more risk factors in addition to menopause
  • All women ages 65 and older
  • Postmenopausal women with fractures
  • Women who are thinking about treatment for osteoporosis
  • Women who have been on hormone therapy for a long time
  • Men or women with certain health conditions or who are taking certain medicines (such as glucocorticoids or prednisone) for a long time

People who develop osteoporosis from another condition should work with their health care provider to identify and treat the underlying cause. For example, if you take a medication that causes bone loss, your doctor may lower the dose of that medication or switch you to another medication. If you have a disease that requires long-term glucocorticoid therapy, such as rheumatoid arthritis or chronic lung disease, you can also take certain medications approved for the prevention or treatment of osteoporosis.

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Mayo Clinic lists multiple treatment options for osteoporosis:

  • Bisphosphonates: For both men and women at increased risk of fracture, the most widely prescribed osteoporosis medications are bisphosphonates. 
  • Denosumab (Prolia, Xgeva): produces similar or better bone density results and reduces the chance of all types of fractures. Denosumab is delivered via a shot under the skin every six months.
  • Hormone related therapy
  • Bone-building medications
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