Osteoporosis
Osteoporosis is a condition that weakens bones, making them fragile and more prone to fractures. It develops slowly over several years and is often only diagnosed when a minor fall or sudden impact causes a bone to break.
Bone density naturally decreases with age, but certain factors accelerate this process. These include reduced oestrogen levels after the menopause, long-term use of corticosteroids, family history, low body weight and conditions affecting nutrient absorption.
There are often no warning symptoms until a fracture occurs. Common fracture sites include the wrist, hip and spinal vertebrae.
Bone resorption markers such as deoxypyridinoline measure the rate of bone breakdown and can be used alongside DEXA scanning to assess bone health. Adequate vitamin D, calcium, weight-bearing exercise and, where appropriate, medication all play a role in prevention and management.
Causes of Osteoporosis
Osteoporosis develops when the rate of bone resorption (breakdown) exceeds the rate of new bone formation. Several factors contribute:
- Menopause is the most significant cause in women. The decline in oestrogen accelerates bone loss, with women losing up to 20% of bone density in the five to seven years following menopause
- Age, as bone density naturally decreases from around age 35 onwards in both sexes
- Long-term corticosteroid use (such as prednisolone) directly impairs bone formation and is one of the most common causes of secondary osteoporosis
- Family history of osteoporosis or hip fracture
- Low body weight (BMI below 18.5)
- Conditions affecting nutrient absorption such as coeliac disease, Crohn's disease and inflammatory bowel disease
- Hormonal conditions including hyperthyroidism, hyperparathyroidism, low testosterone in men and early menopause
- Lifestyle factors including smoking, excessive alcohol, physical inactivity and inadequate dietary calcium and vitamin D
Tests that can help check this condition
Learn more on the official NHS page .
