Bone loss before osteoporosis (osteopenia)
The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis.
Osteopenia does not always lead to osteoporosis. It depends on many factors.
If you have osteopenia, there are steps you can take to keep your bones healthy and reduce your risk of developing osteoporosis.
Your doctor may also prescribe one of the bone-strengthening treatments that are given to people with osteoporosis, depending on how weak your bones are and your risk of breaking a bone.
Who's affected by osteoporosis?
Osteoporosis affects over 3 million people in the UK.
More than 500,000 people receive hospital treatment for fragility fractures (bones that break after falling from standing height or less) every year as a result of osteoporosis.
Causes of osteoporosis
Losing bone is a normal part of ageing, but some people lose bone much faster than normal. This can lead to osteoporosis and an increased risk of broken bones.
Women also lose bone rapidly in the first few years after the menopause. Women are more at risk of osteoporosis than men, particularly if the menopause begins early (before the age of 45) or they've had their ovaries removed.
However osteoporosis can also affect men, younger women and children.
Many other factors can also increase the risk of developing osteoporosis, including:
- taking high-dose steroid tablets for more than 3 months.
- other medical conditions – such as inflammatory conditions, hormone-related conditions, or malabsorption problems
- a family history of osteoporosis – particularly a hip fracture in a parent
- long-term use of certain medicines that can affect bone strength or hormone levels, such as anti-oestrogen tablets that many women take after breast cancer
- having or having had an eating disorder such as anorexia or bulimia
- having a low body mass index (BMI)
- not exercising regularly
- heavy drinking and smoking
Read more about the causes of osteoporosis.
Diagnosing osteoporosis and osteopenia
If your doctor suspects you have osteoporosis, they can work out your future risk of breaking a bone using an online programme, such as FRAX or Q-Fracture.
Bone density scan (DEXA scan)
They may also refer you for a bone density scan to measure your bone strength. It's a short, painless procedure that takes 10 to 20 minutes, depending on the part of the body being scanned.
Your bone density can be compared to that of a healthy young adult.
The difference is calculated as a standard deviation (SD) and is called a T score.
Standard deviation is a measure of variability based on an average or expected value. A T score of:
- above -1 SD is normal
- between -1 and -2.5 SD shows bone loss and is defined as osteopenia
- below -2.5 shows bone loss and is defined as osteoporosis
Treatment for osteoporosis is based on treating and preventing broken bones, and taking medicine to strengthen your bones.
The decision about whether you need treatment depends on your risk of breaking a bone in the future. This will be based on a number of factors such as your age, sex and the results of your bone density scan.
If you need treatment, your doctor can suggest the safest and most effective treatment plan for you.
Read more about how osteoporosis is treated.
If you're at risk of developing osteoporosis, you should take steps to help keep your bones healthy. This may include:
- taking regular exercise to keep your bones as strong as possible
- healthy eating – including foods rich in calcium and vitamin D
- taking a daily supplement containing 10 micrograms of vitamin D
- making lifestyle changes – such as giving up smoking and reducing your alcohol consumption
Read more about preventing osteoporosis.
Living with osteoporosis
To help you recover from a fracture, you can try using:
- hot and cold treatments such as warm baths and cold packs
- transcutaneous electrical nerve stimulation (TENS) – where a small battery-operated device is used to stimulate the nerves and reduce pain
- relaxation techniques
Speak to your GP or nurse if you're worried about living with a long-term condition. They may be able to answer any questions you have.
You may also find it helpful to talk to a trained counsellor or psychologist, or other people with the condition.
Read more about living with osteoporosis.
The Royal Osteoporosis Society is the UK's national charity for osteoporosis.
It has detailed information on osteoporosis prevention and treatment.
It can put you in touch with local support groups. It also has a free telephone helpline that may be particularly helpful if you're newly diagnosed with osteoporosis.
Social care and support guide
- need help with day-to-day living because of illness or disability
- care for someone regularly because they're ill, elderly or disabled, including family members
Our guide to care and support explains your options and where you can get support.