Osteoporosis Risk Factors
Bone loss is often gradual and painless, with no visible symptoms, making osteoporosis difficult to detect. As a result, doctors recommend screening for risk factors and diagnostic testing for those who may be at risk of developing osteoporosis.
There are two types of risks: Risks you can potentially change and risks you can’t change. If you learn that you are at risk for osteoporosis, it is important to speak to your doctor about a bone mineral density (BMD) test.
Risk Factors You Can’t Change
Although you cannot change certain risk factors, it is important to be aware of them. If you discover you are at risk, talk to your doctor about steps you can take to reduce bone mineral loss.
A previous fracture raises the risk of future fracture by 86%, compared to people who have not had a prior fracture.
Fragility fractures are fractures that occur from low energy trauma or an event that would not be expected to cause a fracture. They typically include osteoporotic fractures from falling from standing height or less and most commonly occur at the hip, spine, and forearm.
Secondary Risk Factors
Secondary risk factors are conditions and medications that can weaken bones and affect balance (increasing fracture risk). These secondary risk factors include:
Medical Conditions
- COPD (chronic obstructive pulmonary disease)
- Chronic kidney disease
- Chronic liver disease
- Diabetes
- Endocrine disorders
- Gastrointestinal issues:
- Celiac disease
- Crohn’s disease
- Ulcerative colitis
- Hysterectomy if accompanied by removal of the ovaries
- Immobility
- Rheumatoid arthritis
-
Sex hormone deficiencies (hypogonadism):
-
Early stoppage of periods (amenorrhea) in women due to:
- Eating disorders
- Exercise-induced amenorrhea
- Chronic illness (e.g., endometriosis)
- Pituitary disease
-
Low levels of testosterone in men due to:
- Aging
- Chronic illness
- Liver disease
- Pituitary disease
-
Early stoppage of periods (amenorrhea) in women due to:
Medical Treatments
- Antacids
- Aromatase inhibitors
- Certain anticonvulsants
- Certain antiepileptic drugs
- Certain antipsychotics
- Certain immunosuppressants (calmodulin/calcineurine phosphatase inhibitors)
- Certain steroid hormones (medroxyprogesterone acetate, leutenising hormone-releasing hormone agonists)
- Glucocorticosteroids
- Lithium
- Methotrexate
- Proton pump inhibitors
- Thyroid hormone treatment (L-Thyroxine)
Risk Factors You May Be Able to Change
While some risk factors are uncontrollable, certain risks can be reduced through various lifestyle changes.

