AgePage

National Institute on Aging

2

Osteoporosis:

The Bone Thief

Helen grew up on a farm in the Midwest. 

She drank lots of milk as a child. She also 

walked a lot. After graduating from high 

school, she got married and found a job. 

Family and work, she said, kept her too busy 

to exercise. Helen went through menopause 

at age 47. At 76, she was enjoying retirement 

— traveling and working in 

her garden. But then 

she slipped on a small 

rug in her kitchen and 

broke her hip. After 

Helen recovered, she 

needed a cane to walk, 

and gardening was a lot 

harder to enjoy.

Helen has osteoporosis, but she didn’t 

know it before she fell. Osteoporosis is a 

disease that weakens bones to the point 

where they break easily—most often 

bones in the hip, backbone (spine), and 

Normal Bone Bone With 

Osteoporosis

wrist. Osteoporosis is called the “silent 

disease”—because you may not notice 

any changes until a bone breaks. All 

the while, though, your bones had 

been losing strength for many years.

Bone is living tissue. To keep 

bones strong, your body breaks 

down old bone and replaces it with 

new bone tissue. As people enter 

their 40s and 50s, more bone may 

be broken down than is replaced. A 

close look at the inside of bone shows 

something like a honeycomb. When 

you have osteoporosis, the spaces in 

this honeycomb grow larger. And the 

bone that forms the honeycomb gets 

smaller. The outer shell of your bones 

also gets thinner. All of this makes 

your bones weaker. 
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Who Has Osteoporosis?

Ten million Americans have 

osteoporosis. They 

are mostly women, 

but men also have 

this disease. White 

and Asian women are 

most likely to have 

osteoporosis. Other 

women at great risk 

include those who:

F Have a family history of broken 

bones or osteoporosis 

F Have broken a bone while an adult 

F Had surgery to remove their ovaries 

before their periods stopped 

F Had early menopause 

F Have not gotten enough calcium 

throughout their lives 

F Had extended bed rest 

F Used certain medicines for a 

long time 

F Have a small body frame 

The risk of osteoporosis grows as you 

get older. At the time of menopause, 

women may lose bone quickly for several 

years. After that, the loss slows down but 

continues. In men, the loss of bone mass 

is slower. But, by age 65 or 70, men and 

women are losing bone at the same rate.

What Is Osteopenia? 

Around 34 million more Americans 

have osteopenia. Whether your doctor 

calls it osteopenia or just says you have 

low bone mass, consider it a warning. 

Bone loss has started, but you can still 

take action to keep your bones strong 

and maybe prevent osteoporosis later 

in life. That way you will be less likely to 

break a wrist, hip, or vertebrae (bone in 

your spine) when you are older. 

Can My Bones Be Tested? 

For some people the first sign of 

osteoporosis is to realize they are getting 

shorter or to break a bone easily, like 

Helen did. Don’t wait until that happens 

to see if you have osteoporosis. You 

can have a bone density test to find out 

how strong your bones are. Your doctor 

may suggest a type of bone density test 

called a DXA test (dual-energy x-ray 

absorptiometry) if you are a woman age 

65 or older or if he or she thinks you are 

at risk for osteoporosis.

The DXA test gives you important 

information to help you understand 

your risk for a fracture or broken bone. 

It could show that you have normal bone 

density. Or, it could show that you have 

low bone mass or even osteoporosis.
5 6

How Can I Keep My Bones 

Strong? 

There are things you should do at 

any age to prevent weakened bones. 

Eating foods that are rich in calcium and 

vitamin D is important. So is including 

regular weight-bearing exercise in your 

lifestyle. Here are things you can do to 

keep your bones strong and healthy.

Calcium. Getting enough calcium 

all through your life helps to build and 

keep strong bones. People over age 50 

need 1,200 mg of calcium every day. 

Foods that are high in calcium are the 

best source. For example, eat low-fat 

dairy foods, canned fish with soft bones 

such as salmon, and some dark-green 

leafy vegetables. Check the labels on 

foods like orange juice, breads, and 

cereals to find those with calcium added.

If you think you aren’t getting enough 

calcium in your diet, check with 

your doctor first. He or she 

may tell you to try a calcium 

supplement. Calcium 

carbonate and 

calcium citrate are 

two common forms. You 

have to be careful though. 

Too much calcium can cause 

problems for some people. 

On most days, you should not get more 

than 2,500 mg of total calcium. That 

includes calcium from all sources—foods, 

drinks, and supplements. 

Vitamin D. Your body uses vitamin D 

to absorb calcium. Most people’s bodies 

are able to make enough vitamin D if they 

are out in the sun without sunscreen for 

10 to 15 minutes at least twice a week. 

You can also get vitamin D from eggs, 

fatty fish, and cereal and milk fortified 

with vitamin D. If you think you are not 

getting enough vitamin D, check with 

your doctor. Each day you should have:

F 400 IU (International Units) if you 

are age 51 to 70 

F 600 IU if you are over age 70 

As with calcium, be careful. More 

than 2,000 IU of vitamin D each day 

may cause side effects. 

Exercise. Your bones and muscles 

will be stronger if you are physically 

active. Weight-bearing exercises, done 

three to four times a week, are best 

for preventing osteoporosis. Walking, 

jogging, playing tennis, and dancing are 

examples of weight-bearing exercises. 

Try some strengthening and balance 

exercises too. They may help you avoid 

falls, which could cause a broken bone.
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Medicines. Some common 

medicines can make bones weaker. 

These include a type of steroid drug 

called glucocorticoids used for arthritis 

and asthma, some antiseizure drugs, 

certain sleeping pills, treatments 

for endometriosis, and some cancer 

drugs. An overactive thyroid gland 

or using too much thyroid hormone 

for an underactive thyroid can also 

be a problem. If you are taking these 

medicines, talk to your doctor 

about what you 

can do to help 

protect your bones.

Lifestyle. 

People who 

smoke have 

an increased 

chance of breaking a 

bone. For this and many 

other health reasons, stop 

smoking. Limit how much alcohol you 

drink. Too much alcohol can put you at 

risk for falling and breaking a bone.

What Can I Do For My 

Osteoporosis? 

Treating osteoporosis means 

stopping the bone loss and rebuilding 

bone to prevent breaks. Diet and 

exercise can help make your bones 

stronger. But, they may not be enough if 

you have lost a lot of bone density. There 

are also several medicines to think about. 

Some will slow your bone loss, and others 

can help rebuild bone. Talk with your 

doctor to see if one of these might work 

for you:

Bisphosphonates.

These medicines 

stop the breakdown 

of bone and increase 

bone density. They 

can make it less 

likely that you will 

break a bone, most 

of all in your spine, hip, or wrist. Side 

effects may include nausea, heartburn, 

and stomach pain. A few people have 

muscle, bone, or joint pain while using 

these medicines. These pills must be 

taken in a certain way—when you first 

get up, before you have eaten, and with 

a full glass of water. You should not lie 

down, eat, or drink for at least one-half 

hour after taking the drug. Even if you 

follow the directions closely, these drugs 

can cause serious digestive problems, 

so be aware of any side effects. These 

pills are available in once-daily, once-aweek, and once-a-month versions. Some 
9 10

bisphosphonates are given by injection 

once every 3 months or once a year.

Raloxifene. This drug is used to 

prevent and treat osteoporosis. It is 

a SERM (selective estrogen receptor 

modulator). It prevents bone loss and 

spine fractures but may cause hot flashes 

or increase the risk of blood clots in 

some women. 

Estrogen. Doctors sometimes 

prescribe this female hormone around 

the time of menopause to treat 

symptoms like hot flashes or vaginal 

dryness. Because estrogen also slows 

bone loss and increases bone mass in 

your spine and hip, it can be used to 

prevent osteoporosis. But, estrogen use 

is thought to be risky for some women. 

Talk to your doctor. Ask about the 

benefits, risks, and side effects, as well as 

other possible treatments for you. 

Calcitonin. This hormone increases 

bone mass in your spine and can lessen 

the pain of fractures already there. It 

comes in two forms—a shot or nasal 

spray. The shot may cause an allergic 

reaction and has some side effects like 

nausea, diarrhea, or redness in your 

face, ears, hands, or feet. The only side 

effect of the nasal spray is a runny nose 

in some people. 

Calcitonin is most 

useful for women who 

are at least 5 years 

past menopause. 

Parathyroid 

hormone (PTH). Also 

called teriparatide, this shot 

is given daily for up to 2 years 

to postmenopausal women and to men 

who are at high risk for broken bones. It 

improves bone density in the spine and 

hip. Common side effects include nausea, 

dizziness, and leg cramps. 

Denosumab. A shot given twice a 

year, this treatment for postmenopausal 

women with osteoporosis lessens the 

risk of fractures in the spine, wrist, and 

hip. Common side effects include pain 

in the back, arms, legs, and muscles, 

high cholesterol, and bladder infections.

Can I Avoid Falling? 

When your bones are weak, a simple 

fall can cause a broken bone. This can 

mean a trip to the hospital and maybe 

surgery. It might also mean being laid up 
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for a long time, especially in the case of a 

hip fracture. So, it is important to prevent 

falls. Some things you can do are:

F Make sure you can see and hear 

well. Use your glasses or a hearing 

aid if needed. 

F Ask your doctor if any of the drugs 

you are taking can make you dizzy 

or unsteady on your feet. 

F Use a cane or walker if your walking 

is unsteady. 

F Wear rubber-soled and low-heeled 

shoes. 

F Make sure all the rugs and carpeting 

in your house are firmly attached to 

the floor, or don’t have them. 

F Keep your rooms well lit and the 

floor free of clutter. 

F Use nightlights. 

You can find more suggestions in the 

National Institute on Aging’s Falls and 

Fractures AgePage, available 

from the National Institute 

on Aging Information 

Center listed in For 

More Information.

Do Men Have Osteoporosis? 

Osteoporosis is not just a woman’s 

disease. Not as many men have it as 

women do—maybe because most men 

start with more bone density. As they 

age, men lose bone density more slowly 

than women. But, men need to be 

aware of osteoporosis.

Experts don’t know as much about 

this disease in men as they do in 

women. However, many of the things 

that put men at risk are the same as 

those for women:

F Family history 

F Not enough calcium or vitamin D 

F Too little exercise 

F Low levels of testosterone 

F Too much alcohol 

F Taking certain drugs 

F Smoking

Older men who break a bone easily 

or are at risk for osteoporosis should 

talk with their doctors about testing and 

treatment. 
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For More Information 

Here are some helpful resources:

Food and Drug Administration

10903 New Hampshire Avenue

Silver Spring, MD 20993-0002

1-888-463-6332 (toll-free)

www.fda.gov

National Institutes of Health

Osteoporosis and Related Bone 

Diseases—National Resource Center

2 AMS Circle

Bethesda, MD 20892-3676

1-800-624-2663 (toll-free)

1-202-466-4315 (TTY)

www.bones.nih.gov

National Library of 

Medicine

MedlinePlus

www.medlineplus.gov

National Osteoporosis 

Foundation

1150 17th Street, NW, Suite 850

Washington, DC 20036

1-800-231-4222 (toll-free) 

1-202-223-2226

www.nof.org

National Institutes of Health 

U.S. Department of Health and 

Human Services

August 2010

For more information on health and 

aging, contact:

National Institute on Aging 

Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

1-800-222-2225 (toll-free)

1-800-222-4225 (TTY/toll-free)

www.nia.nih.gov

www.nia.nih.gov/Espanol

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