Your body is constantly remaking your bones. Cells called osteoclasts break down old bone, while osteoblasts build new bone. It’s called the bone remodeling cycle. When you’re young, your body builds new bone as fast as it breaks down old bone. But as you get older, the osteoclasts start outworking the osteoblasts. Your bones don’t get enough of the minerals they need. They get softer and weaker, increasing your risk of breaking bones. That’s osteoporosis.

Women — especially women over 65 — are more likely than men to get osteoporosis. The hormone estrogen plays a large role in the bone remodeling cycle, so when women enter menopause and their estrogen levels fall, they’re more at risk for osteoporosis. Some medications can increase your rate of bone loss. A low-activity lifestyle, heavy alcohol consumption and smoking are all associated with a higher risk of osteoporosis. 

Healthy bones look solid. Bones with osteoporosis look a little like a sponge, with holes and pits in the surface of the bone that weaken its structure. Most people don’t know they have osteoporosis unless they need a bone mineral density (BMD) test.

Osteoporosis is diagnosed through a BMD test. The most common form of BMD test is called dual-energy X-ray absorptiometry (DXA) scan. It measures your bones’ thickness where they’re likely to fracture, such as your backbones (vertebrae) and the bones around your hip joint. 

Caring for osteoporosis can be a team effort. Rheumatologists — doctors who specialize in treating inflammatory conditions like rheumatoid arthritis (RA) — will often spot and diagnose osteoporosis because RA is a risk factor. Endocrinologists also treat osteoporosis, especially when it stems from parathyroid issues or a loss of sex hormones (estrogen or testosterone). Orthopedic surgeons encounter osteoporosis while treating the fractures it causes. 

Osteopenia is a milder or earlier form of osteoporosis. Functionally, they’re the same condition, but osteoporosis is further along than osteopenia. 

A bone density scan or DXA is a painless, non-invasive exam that uses a dual-energy X-ray absorptiometry machine. The scan usually takes less than 15 minutes. It measures your bone density and helps determine your risk for osteoporosis in the hips, spine and other bones.

With the results of a DXA exam, your doctor can make recommendations that will help you strengthen weak bones and prevent or slow down osteoporosis. These might include medications, healthy diet and weight-bearing exercise.

If you’re in any of the following groups, you should have a DXA:

• Women over age 65
• Men over age 70
• Anyone who has broken a bone at age 50⁺
• Women with risk factors for osteoporosis who are of menopausal age or who are postmenopausal but under 65
• Men age 50 to 69 with risk factors for osteoporosis

We also recommend bone density scans for people with breaks or bone loss in their spines, height loss of more than a half-inch within 1 year, or total height loss of 1.5 inches or more from original height.