Osteoporosis affects millions of older adults in the United States

Osteoporosis is common. The National Institutes of Health estimates that about 1 in 3 women over age 70 and 1 in 5 men over age 70 have osteoporosis. That means millions of Americans are living with bones that have become thinner and more fragile than normal. Many more have a related condition called low bone mass, which puts them at higher risk but has not yet reached the osteoporosis threshold.

The actual number of people with osteoporosis varies depending on how it is measured — whether doctors use bone density scans, whether they count only diagnosed cases, or whether they include people who have the condition but do not know it yet. What matters for you is understanding whether your own risk is higher than average, and what you can do about it.

Key Takeaways

  • About 1 in 3 women over 70 and 1 in 5 men over 70 have osteoporosis, making it a common condition in older age.
  • Women lose bone density faster after menopause because estrogen levels drop, which is why osteoporosis is more common in women than men at the same age.
  • Your risk rises with age, family history, small body frame, low physical activity, and certain medications like corticosteroids.
  • Many people have osteoporosis without knowing it because there are usually no symptoms until a bone breaks.
  • A bone density scan (DEXA scan) is the standard way to find out whether you have low bone mass or osteoporosis.

Why osteoporosis is more common in women

Women are diagnosed with osteoporosis more often than men, especially after age 50. The main reason is menopause. When estrogen levels drop during menopause, bone loss speeds up. Women can lose 1 to 3 percent of bone mass per year in the years right after menopause, while men lose bone more slowly throughout their lives.

By age 65, osteoporosis affects roughly 1 in 4 women but only 1 in 12 men. This gap narrows in very old age — men's risk rises as they age — but women still have higher rates overall. A woman's lifetime risk of breaking a hip due to osteoporosis is about 1 in 3, compared to 1 in 12 for men.

Age is the strongest risk factor

The older you are, the more likely you are to have osteoporosis. Bone density naturally declines with age in both men and women. Most people reach their peak bone mass in their late 20s or early 30s, and then bone loss gradually outpaces bone formation.

For women, the steepest bone loss happens in the first 5 to 10 years after menopause. For men, bone loss accelerates around age 70. By age 80, osteoporosis becomes very common — affecting roughly 1 in 2 women and 1 in 4 men. Age alone does not mean you will have osteoporosis, but it does mean your bones are changing and deserve attention.

Family history and body size matter

If your parents or siblings have osteoporosis or have broken a bone from a minor fall, your own risk is higher. Bone density is partly inherited — you are born with a certain genetic potential for how dense your bones can be. You cannot change your genes, but knowing your family history helps you and your doctor decide whether screening makes sense for you.

People with a smaller body frame also have higher risk. If you are naturally thin or have a small frame, you started adulthood with less total bone mass than people with larger frames. That smaller reserve means you have less room for bone loss before osteoporosis develops. This is one reason why screening recommendations sometimes differ based on body weight.

Lifestyle and medication affect your bones

How active you are matters. People who are sedentary lose bone faster than people who move regularly. Weight-bearing exercise — walking, dancing, climbing stairs, strength training — signals your bones to stay strong. People who are inactive for long periods, whether from illness, injury, or choice, often see bone loss accelerate.

Certain medications also increase osteoporosis risk. Long-term use of corticosteroids (like prednisone) for conditions such as rheumatoid arthritis or chronic obstructive pulmonary disease can weaken bones. Some cancer treatments, seizure medications, and thyroid medications affect bone density too. If you take any of these regularly, your doctor may recommend bone density screening even if you have no other risk factors.

Nutrition plays a role as well. Low calcium and vitamin D intake, heavy alcohol use, and smoking all contribute to bone loss. These are factors you can influence through your daily choices.

Many people do not know they have osteoporosis

Osteoporosis is sometimes called a silent disease because you usually feel nothing until a bone breaks. You cannot feel your bones getting thinner. There is no pain, no warning sign, no symptom that tells you bone loss is happening. Some people discover they have osteoporosis only after they fall and break a hip, wrist, or vertebra.

This is why screening is important, especially if you have risk factors. A bone density scan can detect low bone mass or osteoporosis before a fracture happens. Knowing your bone density gives you and your doctor time to make changes — through exercise, nutrition, or medication — that can slow bone loss or even build bone back.

Screening recommendations vary by age and sex

The U.S. Preventive Services Task Force recommends bone density screening for all women age 65 and older, and for postmenopausal women under 65 who have risk factors. For men, screening is recommended starting at age 70, or earlier if you have risk factors such as low body weight, family history, or use of corticosteroids.

If you are younger but have multiple risk factors — such as a family history of osteoporosis, low body weight, long-term corticosteroid use, or a history of fractures — talk with your doctor about whether screening makes sense for you. Screening is not urgent or emergency, but it is a conversation worth having if you fall into a higher-risk group.

Frequently Asked Questions

Is osteoporosis hereditary?

Bone density is partly inherited, so if your parents or siblings have osteoporosis, your risk is higher. However, inheritance is not destiny — lifestyle factors like exercise, calcium intake, and smoking also play a major role. Knowing your family history helps your doctor decide whether screening is right for you.

Can men get osteoporosis?

Yes. About 1 in 5 men over age 70 have osteoporosis. Men's risk rises with age, especially after 70, and is higher if they have low body weight, family history, or use corticosteroids. Men are screened less often than women, so some cases go undetected until a fracture occurs.

What is the difference between low bone mass and osteoporosis?

Low bone mass (also called osteopenia) means your bones are thinner than normal but not yet thin enough to be called osteoporosis. It is a warning sign that bone loss is happening and that you should focus on exercise, nutrition, and other preventive steps. Osteoporosis is the more advanced stage, where fracture risk is significantly higher.

At what age should I get screened for osteoporosis?

Women should start at age 65, and men at age 70. If you are younger but have risk factors — such as family history, low body weight, long-term corticosteroid use, or a previous fracture — ask your doctor whether screening makes sense for you now.

Can osteoporosis be reversed?

Osteoporosis cannot be completely reversed, but bone loss can be slowed or stopped with exercise, good nutrition, and sometimes medication. Some people can even regain small amounts of bone density. The goal is to prevent fractures and maintain the bone you have.