Osteoporosis is a disease of the bones that causes bones to become weak and break easily. Osteoporosis affects mostly older women, but prevention starts when you are younger. No matter your age, you can take steps to build bone mass and prevent bone loss. Broken bones from osteoporosis cause serious health problems and disability in older women.

Osteoporosis is called a “silent” disease. You may have bone loss for many years without any symptoms until you break a bone. A broken bone can cause severe pain and disability. It can make it harder to do daily tasks on your own, such as walking.

Osteoporosis affects more women than men. Of the estimated 10 million Americans with osteoporosis, more than 8 million (or 80%) are women.

Women are more likely to get osteoporosis because:

• Women usually have smaller, thinner, less dense bones than men.
• Women often live longer than men. Bone loss happens naturally as we age.
• Women also lose more bone mass after menopause with very low levels of the hormone estrogen. Higher estrogen levels before menopause helps protect bone density.

Osteoporosis is most common in older women. In the United States, osteoporosis affects one in four women 65 or older. But younger women can get osteoporosis. And girls and women of all ages need to take steps to protect their bones.

Yes. Your risk for osteoporosis is higher if you:

• Are past menopause. After menopause, your ovaries make very little of the hormone estrogen. Estrogen helps protect bone density. Some women lose up to 25% of bone mass in the first 10 years after menopause.
• Have a small, thin body (weigh less than 127 pounds)
• Have a family history of osteoporosis
• Are Mexican-American or white. One in four Mexican-American women and about one in six white women over 50 years old have osteoporosis. Asian-American women also have a higher risk for osteoporosis because they are usually smaller and thinner than other women and therefore may have less bone density.
• Do not get enough calcium and vitamin D. Calcium and vitamin D work together to build and maintain strong bones.
• Do not get enough physical activity. Women of all ages need to get regular weight-bearing physical activity, such as walking, dancing, or playing tennis, to help build and maintain bone density.
• Have not gotten your menstrual period for three months in a row (called amenorrhea). If you have amenorrhea and you are not pregnant, breastfeeding, or taking a medicine that stops your periods, talk to your doctor or nurse. Not getting your period means your ovaries may have stopped making estrogen.
• Have an eating disorder. Eating disorders, especially anorexia nervosa and bulimia nervosa, can weaken your bones. Anorexia can also lead to amenorrhea.
• Smoke. Women who smoke have lower bone density and often go through menopause earlier than nonsmokers. Studies also suggest that smoking raises your risk for broken bones, and this risk goes up the longer you smoke and the more cigarettes you smoke.
• Have a health problem that raises your risk of getting osteoporosis. These include diabetes,premature ovarian failure,celiac disease and inflammatory bowel disease, and depression.
• Take certain medicines to treat long-term health problems, such as arthritis, asthma, lupus, or thyroid disease.
• Drink too much alcohol. For women, experts recommend no more than one alcoholic drink a day if you choose to drink alcohol. Long-term, heavy drinking can cause many health problems, including bone loss, heart disease, and stroke.

Osteoporosis is caused by bone loss. Most often, the reason for bone loss is very low levels of the hormone estrogen. Estrogen plays an important role in building and maintaining your bones.

The most common cause of low estrogen levels is menopause. After menopause, your ovaries make very little estrogen.

Also, your risk for developing osteoporosis is higher if you did not develop strong bones when you were young. Girls develop 90% of bone mass by age 18. If an eating disorder, poor eating, lack of physical activity, or another health problem prevents you from building bone mass early in life, you will have less bone mass to draw on later in life.

Maybe. Your unborn baby needs calcium to help his or her bones grow. While in the womb, babies get calcium from what you eat (or the supplements you take). If you don't get enough calcium from food or supplements, your baby will use the calcium in your bones.

You can lose some bone density during pregnancy, but any bone mass lost is usually restored after childbirth (or after breastfeeding). Also, during pregnancy, you absorb calcium from food and supplements (like prenatal vitamins) better than women who are not pregnant. Your body also makes more of the hormone estrogen, which protects bone.

Yes, women often lose some bone density during breastfeeding. But this loss is temporary. Several studies have shown that when women lose bone mass during breastfeeding, they recover full bone density within six months after breastfeeding stops.

You may not have any symptoms of osteoporosis until you break (fracture) a bone. A fracture can happen in any bone of the body. But fractures are most common in the hip, wrist, and spine (vertebrae). Vertebrae support your body, helping you to stand and sit up.

Osteoporosis in the vertebrae can cause serious problems for women. A fracture in this area can happen during day-to-day activities like climbing stairs, lifting objects, or bending forward when you have osteoporosis.

Fractures in the vertebrae can cause it to collapse and bend forward. If this happens, you may get any or all of these symptoms:

• Sloping shoulders
• Curve in the back
• Height loss
• Back pain
• Hunched posture

Your doctor will do a bone density test to see how strong or weak your bones are. A common test is a central dual-energy x-ray absorptiometry (DXA). A DXA is a special type of x-ray of your bones. This test uses a very low amount of radiation.

Your doctor may also use other screening tools to predict your risk of having low bone density or breaking a bone.

Your doctor may suggest a bone density test for osteoporosis if:

• You are 65 or older
• You are younger than 65 and have risk factors for osteoporosis. Bone density testing is recommended for older women whose risk of breaking a bone is the same or greater than that of a 65‑year‑old white woman with no risk factors other than age. Ask your doctor or nurse whether you need a bone density test before age 65.

Screening for osteoporosis is covered by most insurance plans, including Medicare Part B. Depending on your insurance plan, you may be able to get screenings at no cost to you.

• If you have insurance, check with your insurance provider to find out what's included in your plan.
• If you have Medicare, find out about Medicare coverage for bone density tests.
• If you have Medicaid, the benefits covered are different in each state, but certain benefits must be covered. Check with your state's Medicaid program to find out what's covered.
• If you don't have insurance, you may be able to get a no-cost or low-cost bone density test. To learn more, find a health center near you by entering your ZIP code in our health clinic finder on the top left side (desktop view) or bottom (mobile view) of this page. To see whether you are eligible for low-cost or no-cost health insurance, visit HealthCare.gov.

If you have osteoporosis, your doctor may prescribe medicine to prevent more bone loss or build new bone mass. The most common types of medicine to prevent or treat osteoporosis include:

• Bisphosphonates. Bisphosphonates help treat bone loss. They may also help build bone mass.
• Selective estrogen receptor modulators (SERMs). SERMs may help slow the rate of bone loss after menopause.
• Denosumab. This injectable drug may help reduce bone loss and improve bone strength if you are past menopause and at higher risk for broken bones from osteoporosis.
• Calcitonin. Calcitonin is a hormone made by your thyroid gland that helps regulate calcium levels in your body and build bone mass. Taking calcitonin can help slow the rate of bone loss.
• Menopausal hormone therapy. Often used to treat menopausal symptoms, menopausal hormone therapy may also help prevent bone loss. The Food and Drug Administration recommends taking menopausal hormone therapy at the lowest dose that works for your menopause symptoms for the shortest time needed.
• Parathyroid hormone or teriparatide. Teriparatide is an injectable form of human parathyroid hormone. It helps the body build up new bone faster than the old bone is broken down.

Your doctor may also suggest getting more calcium, vitamin D, and physical activity.

All medicines have risks. For example, menopausal hormone therapy may raise your risk of a blood clot, heart attack, stroke, breast cancer, or gallbladder disease. Talk to your doctor or nurse about the benefits and risks of all medicines.

One of the best ways to prevent weak bones is to work on building strong ones. Building strong bones during childhood and the teen years is important to help prevent osteoporosis later.

As you get older, your bones don't make new bone fast enough to keep up with the bone loss. And after menopause, bone loss happens even more quickly. But you can take steps to slow the natural bone loss with aging and to prevent your bones from becoming weak and brittle.

• Get enough calcium and vitamin D each day.
• Get active. Choose weight-bearing physical activities like running or dancing to build and strengthen your bones.
• Don't smoke. Smoking raises your risk for broken bones.
• If you drink alcohol, drink in moderation (for women, this is one drink a day at most). Too much alcohol can harm your bones. Also, too much at one time or mixed with certain medicines can affect your balance and lead to falls.
• Talk to your doctor about whether you need medicine to prevent bone loss.

Osteoporosis that is not treated can lead to serious bone breaks (fractures), especially in the hip and spine. One in three women is likely to have a fracture caused by osteoporosis in her lifetime.

• Hip fractures can cause serious pain and disability and require surgery.
• Spinal fractures can cause you to lose height or get a stooped back. They often cause serious pain and require surgery.

Fractures can happen after minor falls, stumbles, or bumps into furniture. Falls are the leading cause of injuries in older adults over age 65.