When to seek medical advice

Early detection is important in osteoporosis. Consider your risk factors, then discuss your prevention strategy with your doctor. If you're a woman, it's best to do this well before menopause.

Tests and diagnosis

Osteopenia refers to mild bone loss that isn't severe enough to be called osteoporosis, but that increases your risk of osteoporosis. Doctors can detect osteopenia or early signs of osteoporosis using a variety of devices to measure bone density.

Dual energy X-ray absorptiometry

The best screening test is dual energy X-ray absorptiometry (DEXA). This procedure is quick, simple and gives accurate results. It measures the density of bones in your spine, hip and wrist — the areas most likely to be affected by osteoporosis — and it's used to accurately follow changes in these bones over time.

Other tests that can accurately measure bone density include:

• Ultrasound
• Quantitative computerized tomography (CT) scanning

Should you have a test?

If you're a woman, the National Osteoporosis Foundation recommends that you have a bone density test if you aren't taking estrogen and any of the following conditions apply to you:

• You're older than age 65, regardless of risk factors.
• You're postmenopausal and have at least one risk factor for osteoporosis, including having fractured a bone.
• You have a vertebral abnormality.
• You use medications, such as prednisone, that can cause osteoporosis.
• You have type 1 diabetes, liver disease, kidney disease, thyroid disease or a family history of osteoporosis.
• You experienced early menopause.

Doctors don't generally recommend osteoporosis screening for men because the disease is less common in men than it is in women.

Complications

Fractures are the most frequent and serious complication of osteoporosis. They often occur in your spine or hips — bones that directly support your weight. Hip fractures usually result from a fall. Although most people do relatively well with modern surgical treatment, hip fractures can result in disability and even death from postoperative complications, especially in older adults. Wrist fractures from falls also are common.

In some cases, spinal fractures can occur without any fall or injury simply because the bones in your back (vertebrae) become so weakened that they begin to compress. Compression fractures can cause severe pain and require a long recovery. If you have many such fractures, you can lose several inches of height as your posture becomes stooped.