Osteoporosis: Understanding Screening, Prevention, and Treatment Options

Osteoporosis is a common condition that causes bones to become thinner and more fragile over time. This can increase the risk of fractures, especially in the hip, spine, and wrist.

Osteoporosis is often called a silent disease because many people do not know they have it until they break a bone. Regular screening can help identify bone loss earlier, when steps can be taken to protect bone health and lower the risk of future fractures.

Ashraf Uddin, DO, an endocrinologist at Riverside Healthcare, shares what to know about osteoporosis risk factors, screening, prevention, and treatment options.

Osteoporosis causes and risk factors

One common cause of osteoporosis is reduced estrogen, which often happens after menopause. People receiving estrogen-blocking therapy as part of cancer treatment may also have a higher risk of bone loss. Men with low testosterone can also be at higher risk.

Long-term use of glucocorticoids or steroid medications can also increase the risk of osteoporosis over time. These medications may be used for conditions such as COPD, joint pain, or inflammation.

People may have a higher risk of osteoporosis if they have:

• A history of menopause or reduced estrogen
• Estrogen-blocking cancer therapy
• Low testosterone
• Long-term steroid use
• Chronic kidney disease or dialysis
• A personal or family history of fractures
• Low body weight or poor nutrition
• Limited physical activity

“People who are on long-term glucocorticoids or steroid injections or pills, whether that’s for COPD or for joint pain, have a much higher increased risk of developing osteoporosis over time.”

Ashraf Uddin, DO

How osteoporosis is diagnosed

The most common screening test for osteoporosis is a DEXA scan, also called a bone density scan. This test uses low-dose X-ray imaging to measure bone density and help determine whether a person has osteoporosis or osteopenia.

Osteopenia means bone density is lower than normal but not low enough to be considered osteoporosis. Knowing this information helps your provider understand your fracture risk and decide whether treatment may be helpful.

“It’s a pretty simple procedure, and it gives us a lot of information. With that, we can determine whether you’re osteoporotic or you’re in a condition called osteopenia.”

Ashraf Uddin, DO

Ways to help protect your bones

The sooner osteoporosis or osteopenia is identified, the sooner you can take steps to help protect your bones. Dr. Uddin recommends getting enough calcium and vitamin D, along with regular weight-bearing exercise.

Calcium-rich foods may include:

• Milk and dairy products
• Cheese
• Yogurt
• Leafy green vegetables
• Nuts
• Calcium-fortified foods and drinks

Weight-bearing and strength-building exercises can also support bone health. These may include walking, stair climbing, resistance training, or other activities recommended by your provider.

“There are a lot of different sources, and ideally we want to get most of it from our diet. Making adjustments where you can is important.”

Ashraf Uddin, DO

Treatment options for osteoporosis

Lifestyle changes can help support bone health, but some people may also need medical treatment. Treatment depends on a person’s bone density, fracture risk, medical history, and personal goals.

Osteoporosis treatment may include:

• Oral medications
• IV infusions
• Injectable medications
• Medications that help preserve existing bone density
• Medications that help build new bone in certain patients

Your provider can help determine which option is most appropriate based on your risk factors and overall health.

“We try to come up with a tailored approach with our patients to see what their goals are and what kind of risk factors they have.”

Ashraf Uddin, DO

When to ask about osteoporosis screening

Women age 65 and older are commonly recommended for osteoporosis screening. Women younger than 65 may also need screening if they have certain risk factors, such as a parent who has broken a hip, low body weight, certain medical conditions, or medications that may weaken bones.

Screening recommendations for men can vary. Men with risk factors, chronic kidney disease, dialysis, long-term steroid use, low testosterone, or a history of fractures should talk with their provider about whether a bone density scan is appropriate.

If you are unsure whether you need screening, your primary care provider or specialist can review your health history and help guide the next step.

Why fracture prevention matters

Preventing fractures is one of the most important goals of osteoporosis care. Hip fractures, in particular, can have a serious impact on mobility, independence, and quality of life for older adults.

“We aren’t just thinking about longevity of life, but also quality of life when we’re treating somebody for osteoporosis and preventing fractures.”

Ashraf Uddin, DO

To learn more about care for osteoporosis and other hormone-related conditions, visit Riverside Diabetes and Endocrinology or view Dr. Ashraf Uddin’s provider profile.