Osteoporosis Mate kōiwi

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 a fall from standing height or less. It affects 1 in 3 women and 1 in 5 men over the age of 50.

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Symptoms of osteoporosis

There are no early warning symptoms or signs with osteoporosis. The first signs can include:

  • a fracture of your wrist, hips, spine, or other bone that happens more easily than it should
  • losing height, as this could be a sign of a compression fracture.

With more severe osteoporosis, you can fracture a bone doing ordinary things like bending, lifting or just getting up from a chair.

Risk factors for osteoporosis

Some people are more likely to get osteoporosis than others. To find out about your bone health, you can do a simple test called Know Your Bones.

Know Your Bones (external link)

You cannot change some of the risk factors that increase your likelihood of getting osteoporosis, such as your sex or age, but you can change others.

Risk factors you may be unable to change include:

  • being female, although men can also develop osteoporosis
  • getting older
  • having a family history of osteoporosis
  • being underweight
  • having certain conditions such as hormone problems, coeliac disease, diabetes, rheumatoid arthritis, breast cancer and prostate cancer
  • using some medications such as prednisone or medications for epilepsy
  • early menopause
  • having a hysterectomy or your ovaries removed.

You can reduce your risk of getting osteoporosis by strengthening your bones. You can achieve this by:

  • keeping physically active
  • getting enough vitamin D and calcium in your diet
  • not smoking
  • not drinking excess alcohol.

Diagnosing osteoporosis

Your healthcare provider can assess your risk of osteoporosis from your medical history and by asking you about your lifestyle. They can look for physical signs of osteoporosis such as previous fractures.

They may suggest you have a bone density scan (also called DEXA scan) to assess your bone health.

Bone density scan — Inside Radiology (external link)

Treating osteoporosis

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Some people have difficulty getting enough calcium from food sources, so your healthcare provider may recommend calcium supplements. There is some disagreement over using calcium supplements, as some studies have shown they increase the risk of heart problems, particularly in older people.

Eating well for healthy bones (internal link)

Your body makes most of the vitamin D it needs in your skin when exposed to sunlight. Vitamin D is essential for having healthy bones and muscles.

Some people, such as those who spend a lot of time indoors and those with dark skin, have difficulty producing enough vitamin D. If you are at risk of having low levels of vitamin D or if you have osteoporosis, your doctor may recommend you take vitamin D tablets such as colecalciferol.

Colecalciferol — My Medicines (external link)

How to get your daily vitamin D (internal link)

Medicines for osteoporosis work by slowing or stopping bone loss. The main types of medication used to treat osteoporosis are:

Bisphosphonates

These medicines work on your bone‑making cells to slow bone loss. They reduce the fracture rate in people with osteoporosis.

Examples of bisphosphonate medication used to treat osteoporosis include alendronic acid (Fosamax) and risedronate tablets.

Risedronate — My Medicines (external link)

You usually take bisphosphonates tablets with vitamin D supplements. A common side effect of these medications may be heartburn and indigestion.

An alternative to tablets is zoledronic acid, which you take as an infusion. You need an infusion every 12 to 18 months.

Zoledronate infusions (internal link)

Hormone replacement therapy (HRT)

HRT used to be a treatment for osteoporosis in women with low estrogen levels (usually due to menopause). This treatment increases bone density and reduces fracture rates. But it can have side effects, so the risks and benefits need to be weighed up for each woman. Older postmenopausal women are particularly vulnerable to these risks.

HRT is used less often today but still has a role in some circumstances. Men with low testosterone levels may also benefit from testosterone replacement.

Selective estrogen receptor modulators (SERMs)

An example of a SERM is raloxifene. It reduces the number of fractures in the spinal column. It works by copying the effects of estrogen on bone, so increases bone density. Postmenopausal women who can't take estrogen might need a SERM.

Other medications

Other medications to treat osteoporosis include denosumab and teriparatide. They're generally only used if other treatment options haven't been successful.

Self care for osteoporosis

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These can help increase your joints' mobility. This is a key part of overall fitness. Being able to bend, extend and rotate your joints helps you prevent muscle injury. Increased flexibility can also help improve your posture.

This includes using free weights, weight machines, resistance bands or water exercises to strengthen muscles and bones in your arms and upper spine. Strength training can also work directly on your bones to slow mineral loss.

These involve doing aerobic exercise while you are on your feet, with your bones supporting your weight. For example, you could be walking, dancing, doing low‑impact aerobics or gardening. These types of exercises work directly on the bones in your legs, hips and lower spine to slow mineral loss.

Preventing falls

A fall at any age can be dangerous but falls become more common and more likely to cause injury after the age of 55. If you have osteoporosis, you are more likely to break a bone if you fall. You might also need a long time to recover.

Learning how to prevent falls can help you to avoid broken bones and the problems they can cause.

Falls — HealthInfo (external link)

The Nymbl app has been developed for people wanting to improve their balance and mobility and reduce their risk of falling.

Nymbl app — Healthify (external link)

This content was written by HealthInfo clinical advisers. It has been adapted for Health Information and Services.

Clinical advisers — HealthInfo (external link)