What Is Osteopenia?

Brittany Dube, MPH
·7 min read
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<p>seksan Mongkhonkhamsao / Getty Images</p>

seksan Mongkhonkhamsao / Getty Images

Medically reviewed by Stuart Hershman, MD

Osteopenia—or low bone density—is a medical condition that occurs when the density or strength of your bones becomes weaker than usual. As a result, it may be common to experience broken bones or osteoporosis, especially if the condition is left untreated.

Most people with osteopenia receive a diagnosis after the age of 60, which is typically due to a natural loss of bone strength as humans age. However, premature infants may also be at risk of developing osteopenia.

While there's no cure for osteopenia, lifestyle changes such as diet and exercise can help strengthen your bones and prevent complications from occurring.

Symptoms

Many people with osteopenia have no idea they have the condition because it's often asymptomatic, meaning that you don't experience symptoms. Unfortunately, sometimes you don't know that your bones are weakening until osteopenia progresses to osteoporosis—a bone disease that causes changes to the density and structure of your bones.

In the rare chance you do experience symptoms, you may feel bone pain, have weakness, and be more likely to have a broken bone or fracture.

Causes

Losing bone mass over time is a normal part of aging. However, not everyone develops osteopenia. In fact, people assigned female at birth are four times more likely to develop osteopenia than those assigned male at birth, and undergoing menopause can accelerate how quickly bones lose density. This is because the sex hormones, testosterone and estrogen, have bone strengthening effects. When estrogen levels decrease during menopause, bones may become weaker.

You may also be more likely to develop the condition if you:





A Note About BMI

Body Mass Index, or BMI, is a biased and outdated metric that uses your weight and height to make assumptions about body fat, and by extension, your health. This metric is flawed in many ways and does not factor in your body composition, ethnicity, sex, race, and age. Despite its flaws, the medical community still uses BMI because it’s an inexpensive and quick way to analyze health data.




Premature Infants and Their Risk of Osteopenia

Many babies born early (before 30 weeks) can experience osteopenia. This happens because the last ten weeks of pregnancy help support bone growth, the fetus' movement in the womb, and the transfer of calcium and phosphorus (important minerals for bones) to the fetus. When these processes don't happen, it can raise an infant's risk of having weakened bones at birth.

Diagnosis

As you get older, your healthcare provider may test you for changes in your bone health. If they think you may be at risk of developing osteopenia, or other bone diseases, they will likely recommend a dual-energy X-ray absorptiometry (DEXA) scan. DEXA scans, also known as bone mineral density scans, help measure your bone strength.

If your provider orders a DEXA scan for you, the results of the test will give them a T-score. This score measures the difference in your bone density compared to an average healthy person's bone density. Here's what the scores can represent:

T-score

Condition

+1 to -1

Normal bone strength or density

-1.1 to -2.4

Osteopenia

-2.5 or less

Osteoporosis

Your healthcare provider can also use your T-score as a baseline for future tests and to check whether treatments are improving or worsening your condition.

Treatment

There's currently no cure for osteopenia, so the goal of treatment is to strengthen your, lower the risk of fractures, and prevent the progression of bone. The first line of treatment for osteopenia is lifestyle changes. However, your provider may sometimes recommend medication, especially if you have a current or past history of bone fractures.

Lifestyle Changes

Your healthcare provider will likely recommend a combination of lifestyle changes to help strengthen your bones and reduce your risk of a broken bone or fracture. These modifications may include:

Medications and Supplements

If you have experienced a broken bone or fracture and have osteopenia, your healthcare provider may also prescribe you medication to reduce your risk of future fractures. There are many kinds of medications that they can prescribe you, but the most common include:

  • Bisphosphonates such as Fosamax (alendronate), Actonel (risedronate), or Reclast (zoledronic acid)

  • Selective estrogen receptor modulators (SERMs) such as Evista (raloxifene) or Nolvadex (tamoxifen)

  • Calcium and vitamin D supplements

Treatment for Infants

Treatment for infants with osteopenia focuses on increasing strength and density in their developing bones.

If your baby has osteopenia, their healthcare provider may recommend:

  • Calcium or phosphorus supplements that you can add to breast milk

  • Special formula for premature babies

  • Vitamin D supplements

How to Prevent Osteopenia

Due to aging bodies, it's not always easy to prevent osteopenia from occurring. However, you can implement some strategies to reduce your condition from worsening or experiencing complications like frequent fractures.

Keep in mind: prevention strategies tend to overall with treatment options since the object of treatment for osteopenia focuses on preventing further bone loss. These prevention strategies may include:

  • Eating a balanced with enough vitamin D and calcium

  • Spending moderate time in sunlight each day (and remembering to wear sunscreen when you're outside)

  • Getting light to moderate exercise each day, such as walking or biking

  • Limiting the use of substances such as alcohol and tobacco

  • Talking to your healthcare provider if you have worsening symptoms and asking for other treatments such as medication

Complications

The most common complications of osteopenia include broken bones, fractures, and the development of osteoporosis—which can happen if osteopenia is left untreated.

To reduce the risk of these complications, your healthcare provider may recommend the following prevention methods:

  • Removing fall hazards such as loose carpets or items on the floor from your home

  • Avoiding using sleep that makes you drowsy

  • Getting your eyesight checked and wearing glasses if needed to prevent the possibility of tripping

  • Keeping soft furniture, beds, and floors in your home to minimize the impact on weakened bones

Living with Osteopenia

Although the initial diagnosis of osteopenia may feel worrisome or scary, it's entirely possible to slow the progression of your bone loss. A combination of lifestyle changes can enable you to continue living a fulfilling life while reducing your risk of fractures or osteoporosis. 

If you're postmenopausal or are concerned about your chances of developing osteopenia, speak to your healthcare provider about getting screened. Early detection can help you protect your bone health for years to come.

Frequently Asked Questions

Is osteopenia a form of arthritis?

Contrary to popular belief, osteopenia is not a form of arthritis. Instead, osteopenia is a measure of bone loss, while arthritis is characterized by joint loss. However, research suggests that having a joint condition like rheumatoid arthritis can increase your risk of developing osteopenia. More research is still needed to understand why the two conditions can sometimes be linked.

What happens if osteopenia is left untreated?

If osteopenia is left untreated, it's possible for your bones to become weaker over time. This can make you more vulnerable to developing osteoporosis or experiencing broken bones or fractures.

Does osteopenia always lead to osteoporosis?

No, osteopenia doesn't always lead to osteoporosis. However, it's important to take preventative actions to reduce the risk of your condition worsening and developing into osteoporosis.

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