Medically Reviewed by James E. Gerace, MD
3 min read

About 18 million Americans have osteopenia, a health problem that can turn into osteoporosis. Bone mineral density is lower than normal. However, it is not yet low enough to be considered osteoporosis.

Not everyone with osteopenia will develop osteoporosis. However, it can turn into osteoporosis if it is not treated. Osteoporosis can result in easily fractured bones and other bone problems.

Bone health is measured in two ways: by density and by mass. Bone mass means how much bone you have. Bone density means how thick the bone is.

To find bone density, your doctor measures the levels of minerals in your bones. These minerals include:

The more dense your bone mineral content, the stronger your bones are.

As people age, calcium and other minerals are absorbed back into the body from the bones. This re-absorption can make the bones weaker. The bones become more vulnerable to fractures and other damage.

Bone mass is the amount of bone you have. Usually, bone mass peaks around age 30. Then bone mass begins to decline. Bone is reabsorbed by your body faster than new bone can be made.

Often, people with osteopenia are not aware they have this problem. In fact, the first sign of osteopenia may be a broken bone. A broken bone may mean that the condition has already become osteoporosis.

The risk factors for developing osteopenia are the same as those for developing osteoporosis. They include:

- Being female

- Being thin and/or having a small frame

- Getting too little calcium in the diet

- Smoking

- Leading an inactive lifestyle

- A history of anorexia nervosa

- A family history of osteoporosis

- Heavy alcohol consumption

- Early menopause

The most accurate way to diagnose osteopenia and osteoporosis is through bone mineral density testing. This is usually done with a dual-energy X-ray absorptiometry (DEXA) scan.

DEXA scan results are reported as T-scores:

  • Normal bone: T-score above -1
  • Osteopenia: T-score between -1 and -2.5
  • Osteoporosis: T-score below -2.5

Other tests can be done to help diagnose osteoporosis and osteopenia. Quantitative ultrasound is one such test. It measures the speed of sound in the bone to assess bone density and strength. DEXA scans are usually still needed to confirm results from ultrasound and other tests.

When should you begin getting bone density screenings? Experts currently recommend that you receive regular bone density scans in these cases:

  • Women 65 and older
  • Women 60 or older with certain risk factors; low body weight is considered the most important

There are no clear guidelines for when to begin screening for women between 60 and 65 who have no other risk factors. Nor are there specific guidelines for women under 60 who have additional risk factors. Work with your doctor to determine a screening plan to meet your needs.

Osteopenia does not have to turn into osteoporosis. You can help prevent this by practicing good bone health:

  • Eat a balanced diet. Include plenty of calcium and vitamin D. You'll find these nutrients in foods like milk, yogurt, cheese, and broccoli.
  • Exercise regularly. Choose weight-bearing exercise like walking, running, or tennis. Also do strength training using weights or resistance bands.
  • Avoid smoking.
  • If you drink, do so in moderation.

For women who have gone through menopause, hormone replacement therapy (HRT) may be an option. It may help prevent bone loss that occurs when the body stops producing estrogen. This may reduce your risk of osteopenia. HRT may also help prevent osteopenia from progressing to osteoporosis. However, HRT is not without risks. Talk with your doctor if you wish to consider using HRT to help prevent osteopenia and osteoporosis.

Show Sources

SOURCES: Medline Plus Medical Encyclopedia: "Osteoporosis." MayoClinic.com: "Bone density test: Measure your risk of osteoporosis." National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Osteoporosis: Peak Bone Mass in Women." Kanis, J. TheJournal of Bone and Mineral Research, 1994; vol 9: pp 1137-41. The Cleveland Clinic: "Osteoporosis." U.S. Preventive Services Task Force: "Screening for Osteoporosis." National Osteoporosis Foundation: "Facts on Osteoporosis." Hans, D. Journal ofClinical Densitometry, 2006 Jan-March 2006; vol 9(1): pp 15-21.

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