As you age, the inside of your bones become porous from a loss of calcium. This is called losing bone mass. Total bone mass tends to peak around age 35. Osteopenia refers to bone mass that is lower than your peak bone mass but not yet low enough to be considered osteoporosis. Osteopenia is not a disease, but if you meet the criteria for osteopenia, you are at higher risk for developing osteoporosis.
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Osteopenia usually doesn’t cause any symptoms. Losing bone mass is not painful. Broken bones or fractures can occur, but these problems tend to happen after osteoporosis has developed.
Your bones are constantly changing. New bone is growing while old bone is being broken down and reabsorbed by your body. When you are young, you grow new bone faster than your body breaks down old bone. This increases your bone mass. Once total bone mass has peaked, you start to lose it because your body is breaking down old bone faster than you can grow new bone. If you lose enough bone mass, your bones may weaken.
The following things put you at increased risk for osteopenia. The more of these that apply to you, the higher your risk is. Talk to your family doctor about your risk factors.
Women are more likely to develop osteopenia than men. This is due to several factors. Women have less bone mass to begin with, tend to live longer and take in less calcium than do men. In women, the rate of bone loss speeds up after menopause, when estrogen levels fall. Since the ovaries make estrogen, faster bone loss will also occur if both ovaries are removed by surgery.
If your doctor suspects you have low bone mass, he or she may suggest you have a bone density test. A common test that measures bone density is called a dual energy X-ray absorptiometry (DEXA). This test measures the density of the bones in your hips, spine and wrist.
It is important to treat low bone mass to keep it from progressing into osteoporosis. Treatment starts with changes to your lifestyle. Your doctor will want you to increase your physical activity, especially weight-bearing exercise. Weight-bearing exercise can help your bones become stronger. It can also build muscle and improve your balance, both of which can help prevent against broken bones. Examples of weight-bearing exercise include walking, jogging and climbing steps.
Your doctor will also suggest ways to get more calcium and vitamin D in your diet. Nonfat and low-fat dairy products, such as yogurt, cheese and milk, are good sources of calcium. Other sources of calcium include dried beans, pink salmon, spinach and broccoli. Some foods, such as orange juice, breads and dry breakfast cereals, may be fortified with calcium or vitamin D or both. Your doctor may suggest a Vitamin D or calcium supplement as well.
Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA by Dawson-Hughes B, Tosteson A, Melton L, Baim S, Favus M, Khosla S and Lindsay R. (Osteoporosis Int April 19, 2008)
John Hopkins Health Alerts. Osteopenia: To Treat or Not to Treat?. Accessed May 11, 2010
Harvard Health Letter. Osteopenia: When you have weak bones, but not osteoporosis. Accessed May 11, 2010
University of Michigan Health System Clinical Care Guidelines Committee. Osteoporosis in Women. Accessed May 11, 2010
Written by familydoctor.org editorial staff