What is osteopenia?

Osteopenia (sometimes spelled osteopaenia) is the medical name for bone density that is lower than normal, but not as severe as osteoporosis.

If you have low bone density, your bones are more fragile, so it can be easier for you to break a bone if you have an accident.

If you have osteopenia, your bones won't be as fragile as they would be if you had osteoporosis. However, it is an early warning sign that you should be taking action to reduce your risk of developing osteoporosis or breaking a bone in the future.

What are the symptoms of osteopenia?

Osteopenia doesn't cause any symptoms. You might only find out that you have it if you break a bone. This could happen after a small accident, such as a knock or a fall.

What causes osteopenia?

Most people find their bone density decreases as they get older.

Females are more likely to have low bone density after menopause. The hormone oestrogen helps keep your bones strong. When oestrogen levels decline after menopause, your bones may become weaker. Females who go through menopause early are at higher risk.

For males, low testosterone levels can be a risk factor.

Osteopenia runs in families. Tell your doctor if someone in your family has been diagnosed with osteoporosis or has broken a bone after a knock or a minor fall.

Lifestyle factors that can put you at risk of osteopenia include:

• not getting enough calcium or vitamin D
• living with obesity or underweight
• not getting enough exercise
• smoking
• drinking large amounts of alcohol

Other causes of osteopenia include:

• health conditions that affect how you absorb food, such as coeliac disease and inflammatory bowel disease
• cystic fibrosis
• chronic health conditions such as diabetes, rheumatoid arthritis, liver disease and kidney disease
• some medicines, such as steroids (if you take them long-term)
• some treatments for breast cancer or prostate cancer
• anorexia nervosa

When should I see my doctor?

See your doctor if you are over age 50 and have had a fracture due to a minor accident. You will need to have a test of your bone density. You may need treatment to prevent you having another fracture.

If you are over 50 years of age and have risk factors for low bone density, talk to your doctor about having a test for osteopenia and osteoporosis.

How is osteopenia diagnosed?

To diagnose osteopenia, your doctor will ask you about your risk factors for developing osteopenia.

If your doctor thinks that you are at risk, you may be referred for a bone density scan (also known as a DEXA scan, bone mineral density test or DXA test). This is a type of x-ray that measures how strong your bones are. During a bone density scan, you will usually have scans taken of your hips and spine.

The results will compare your bone density to that of young, healthy people. This will show if you have normal bone density, osteopenia or osteoporosis.

If you have a bone density test, you should ask your doctor whether you are eligible for a Medicare rebate. You may be eligible if you are over 70 years of age, if you have certain health conditions or if you have had a fracture following a minor accident.

How is osteopenia treated?

There are 3 important things you can do to treat osteopenia:

• Include enough calcium in your diet. Try eating dairy foods, seafood, tinned salmon or sardines (with the bones), broccoli and other foods rich in calcium. Eating at least 3 serves of dairy foods a day should give you the amount of calcium that you need.
• Get enough vitamin D by spending time in the sun each day (but make sure you protect yourself against sunburn). How long you need will depend on the season and where you live. Some foods also contain vitamin D.
• Stay active with weight-bearing exercise, such as brisk walking, jogging, skipping, dancing, aerobics or team sports. Strength training with weights is also important.

If you don't think you're getting enough calcium or vitamin D, talk to your doctor about supplements.

It's important to see your doctor regularly to monitor your bone health.

If you are over 50 years of age and you have had a fracture, your doctor might recommend medicine to improve your bone density.

If you have health conditions that put you at risk of falls, a physiotherapist can help you reduce your risk.

What are the complications of osteopenia?

If you don't take action to improve your bone health, osteopenia can get worse and lead to osteoporosis.

Can osteopenia be prevented?

Most people find their bone density decreases as they get older. Here are some things you can do to keep your bones healthy:

• Include weight-bearing activities and strength training in your exercise routine.
• Make sure you get enough calcium and vitamin D.
• Include protein in your diet.
• Avoid smoking.
• Limit alcohol to less than 2 drinks a day.

If you are female and have gone through menopause, talk to your doctor about whether menopausal hormone therapy (MHT) might help keep your bones healthy. This is especially important if you went through menopause before age 45.

Resources and support

• Healthy Bones Australia has information about bone health.
  • Check their list of calcium-rich foods to see how much calcium is in your daily diet.
  • The sunshine map advises how long to spend in the sun to get enough vitamin D.
• You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Do you prefer to read in languages other than English?

Read Bone health explained, available in English as well as in many other community languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Healthy Bones Australia has information for Aboriginal and/or Torres Strait Islander people about keeping your bones healthy.