Osteoporosis awareness month is a good time to act on a condition that gives no warning. Osteoporosis causes no symptoms until a bone breaks, so the practical steps are simple. Know your risk factors. Ask whether you need a bone density (DEXA) scan. Review your calcium, vitamin D and exercise habits. And make sure that anyone who has already had a low-trauma fracture is assessed and treated. In the United States, May is recognized as National Osteoporosis Month, and World Osteoporosis Day is marked on October 20, but the advice below applies at any time of year.
Why Awareness Campaigns Matter for Bone Health
Health awareness months work because they prompt people to ask questions they would otherwise put off. The same idea drives campaigns for blood cancers, described in our guide to Leukemia Awareness Month. For osteoporosis, the message matters because the first sign is so often a broken hip, wrist or vertebra.
Osteoporosis is the most common metabolic bone disease. Bone and blood are closely linked, since blood cells are made in the marrow inside our bones. This is one reason why, in hematology, we see bone health as part of the same picture.
What Osteoporosis Is
Osteoporosis is a systemic skeletal disorder in which low bone mass and deterioration of bone structure reduce bone strength. It leads to fragility fractures: breaks from a fall at standing height or less, most often at the hip, spine and wrist.
Bone strength has two parts. Bone density is how much mineral the bone contains. Bone quality covers its architecture, turnover, repair of micro-damage and mineralization. DEXA measures bone mineral content per unit area, giving a density figure that doctors use for diagnosis.
Causes and Risk Factors
Bone is renewed constantly through remodeling. In osteoporosis, bone removal by osteoclasts outpaces bone building by osteoblasts. Several factors tip that balance.
Factors you cannot change
- Age: bone density peaks in early adulthood and declines afterwards.
- Sex and menopause: falling estrogen after menopause speeds bone loss in women.
- Family history: particularly a parent who broke a hip.
- Previous fragility fracture: one of the strongest predictors of another.
Factors you can influence
- Low calcium and vitamin D intake.
- Smoking and excessive alcohol consumption.
- Physical inactivity and low body weight.
- Medicines such as long-term corticosteroids, and conditions such as hyperthyroidism, rheumatoid arthritis and malabsorption. These should be reviewed with your doctor.
Signs, Screening and Diagnosis
Osteoporosis is usually silent, but some clues should prompt a check:
- Back pain from a vertebral fracture.
- Loss of height over time.
- A stooped posture (kyphosis).
- A fracture from a minor fall or bump.
Who should be screened
Guidelines generally recommend bone density testing for women aged 65 and over, and for younger postmenopausal women with risk factors. Many also recommend it for men with risk factors, particularly from around age 70. Anyone who has had a fragility fracture, or who takes long-term corticosteroids, should be assessed regardless of age.
Understanding your results
The DEXA scan reports a T-score, which compares your bone density with a healthy young adult’s. Doctors often combine it with FRAX, a tool that estimates 10-year fracture probability from age, sex, weight, prior fractures and other risk factors.
| T-score | Meaning | Typical next step |
|---|---|---|
| -1.0 or higher | Normal bone density | Healthy habits; retest if risk changes |
| Between -1.0 and -2.5 | Low bone mass (osteopenia) | Assess fracture risk with FRAX; treat if risk is high |
| -2.5 or lower | Osteoporosis | Treatment usually recommended |
| Any score plus a fragility fracture | Clinical osteoporosis | Treatment usually recommended |
Blood tests for calcium, vitamin D, kidney, liver and thyroid function help find secondary causes. Bone turnover markers are sometimes used to monitor treatment.
Treatment Options
Medicines
- Bisphosphonates such as alendronate, risedronate and zoledronic acid are usually first-line. They slow bone breakdown and reduce fracture risk.
- Denosumab, a monoclonal antibody given by injection every six months, inhibits osteoclast formation. It should not be stopped without a planned follow-on treatment.
- Anabolic agents such as teriparatide and romosozumab stimulate new bone formation. Romosozumab also reduces bone resorption. These are generally reserved for people at very high risk.
- Hormone-related therapies, including SERMs, may suit some postmenopausal women.
Lifestyle and fall prevention
Adequate calcium, preferably from food, and vitamin D support any treatment. Regular weight-bearing, resistance and balance exercise builds strength and reduces falls. Physical therapy, home safety changes and walking aids help people who have already fallen or fractured.
Five Steps to Take This Awareness Month
- Check your risk. List your risk factors: age, menopause, family history, past fractures, steroid use, smoking and alcohol. Take the list to your next appointment. Your doctor can run a FRAX estimate in a few minutes.
- Ask about a DEXA scan. If you are a woman aged 65 or over, a younger postmenopausal woman with risk factors, or an older man with risk factors, ask whether a scan is due. The test is quick, painless and uses a very low radiation dose.
- Review calcium and vitamin D. Dairy foods, fortified plant milks, canned fish with bones, tofu set with calcium and leafy greens all contribute calcium. Ask your doctor whether you need a vitamin D test or supplement rather than guessing the dose.
- Move every day. Brisk walking, stair climbing, resistance exercise and balance work such as tai chi help bones and muscles. People who already have osteoporosis should ask a physiotherapist which movements are safest for their spine.
- Follow up on any fracture. If you or a relative has broken a bone from a minor fall since turning 50, make sure bone health was checked. This is one of the most commonly missed opportunities in osteoporosis care.
Key Takeaways
- Osteoporosis is silent until a fracture, so screening is how it is found early.
- A DEXA T-score of -2.5 or lower confirms osteoporosis; FRAX helps judge overall fracture risk.
- A fragility fracture at any age should prompt assessment and, usually, treatment.
- Effective medicines exist, and they work best alongside nutrition, exercise and fall prevention.
- Use awareness month as a reminder to book the conversation with your doctor.
Explore more in our osteoporosis guide.
Frequently Asked Questions
When is osteoporosis awareness month?
In the United States, May is National Osteoporosis Month. Internationally, World Osteoporosis Day is held on October 20. Some countries run their own campaigns at other times.
Should men get checked for osteoporosis?
Yes, if they have risk factors. These include older age, long-term steroid use, low testosterone, heavy drinking or a previous fracture. Men are diagnosed less often than women, and are more often missed.
Can osteoporosis be reversed?
Treatment can increase bone density and substantially lower fracture risk, especially with bone-building medicines. Lost bone structure may not return fully to normal, so the realistic goal is to prevent fractures.
How often should a DEXA scan be repeated?
It depends on your results and treatment. Many people on treatment are rescanned every one to two years at first. Those with normal results and few risk factors may wait considerably longer.
