What is the main cause of osteoporosis?

Osteoporosis is a bone disease that causes your bones to be weak and more likely to break. Most people don't know that they have osteoporosis until they break a bone.
Osteoporosis affects about 20% of women aged 50 and over and almost 5% of men aged 50 and over.
The main cause of osteoporosis is bone loss due to low estrogen levels. Estrogen plays a part in maintaining and building bones.
In women, estrogen levels drop significantly during menopause. Men's level of sex hormones decrease more gradually with age.
Who gets osteoporosis?
There are some risk factors linked to osteoporosis. These include:
Age
You can get osteoporosis at any age, but it's usually found in people over 50. After this age, your bones gradually lose their stockpile of essential minerals like calcium.
Body size
You're at greater risk if you're slender and have thin bones. This may be due to:
- Low muscle mass
- Lower estrogen
- Less fat to pad your bones during a fall
- Poor nutrition
Family history
Your risk is higher if one of your parents has a history of hip fracture or osteoporosis.
Gender
Women have a higher chance of developing osteoporosis than men.
When your estrogen levels drop sharply at menopause, the mineral loss from your bones increases. This problem is worse if you have early menopause or ovaries removed before menopause. Your bones then have fewer years to benefit from estrogen.
Medical conditions
Many medical conditions can make your bones more likely to break. These include:
- Disorders that cause hormone imbalances like eating disorders, irregular menstrual periods, and abnormal thyroid hormone levels
- Conditions that reduce your mobility like stroke and paralysis
- Conditions treated with steroid medications, such as lupus, sickle cell disease, and rheumatoid arthritis
Lifestyle factors
Your risk for weak bones is higher if you:
- Don't exercise enough. Your bones maintain their strength from gravity and the pull of your muscles.
- Don't get enough vitamin D and calcium.
- Don't eat enough vegetables and fruits. Besides calcium and vitamin D, your bones need other nutrients like potassium, magnesium, and vitamin K.
- Smoke. Smoking causes damage to your bones.
- Diet often. If you go on rapid weight-loss diets that don't include nutrients, your body may take these nutrients from your bones. This makes them more likely to break.
- Drink a lot. Long-term heavy drinking weakens your bones.
Symptoms of osteoporosis
Osteoporosis is a "silent" disease. You may not have any symptoms until you break a bone. You can fracture any bone in your body, but they happen more often in your hip, wrist, and spine.
A broken bone doesn't sound like a serious condition, but a hip fracture can change your life drastically. About 50% of people with a hip fracture lose their independence. About 20% of people who break their hip die within a year.
If you fracture your spine, this can cause it to collapse. You may have these symptoms:
- Back pain
- Hunched posture
- A curve in your back
- Sloping shoulders
- Loss of height
Testing for osteoporosis
Your doctor will recommend a bone density test to check how strong your bones are. One standard test is central dual-energy x-ray absorptiometry (DXA). This is a type of x-ray of your bones that uses very low radiation.
You may need a bone density test if you're:
- 65 years or older
- Under 65 and have osteoporosis risk factors
How to improve your bone health
You can reduce your risk of osteoporosis by making some lifestyle changes, including:
- Quit smoking
- Limit your alcohol. Women should have no more than two drinks a day. For men, no more than three drinks a day.
- Exercise regularly. Include some weight-bearing activities like walking, tennis, or stair-climbing.
- Get enough calcium and vitamin D in your diet. Most adults with osteoporosis need about 1,300 milligrams of calcium and 800 international units of vitamin D daily. Talk to your doctor to determine how much calcium and vitamin D you need.
Prevent falls at home
Many things can make you fall. These are some ways to help prevent a fall.
- Have your eyesight and hearing tested. Wear your glasses or hearing aid if you need them.
- Stand up slowly. When you get up quickly, your blood pressure can drop and make you feel giddy.
- Wear shoes with non-skid soles that support your feet well.
- Be careful when walking on slippery or icy surfaces.
- Get enough sleep. Being sleepy can make you more prone to falling.
- Drink less alcohol. Even a tiny amount of alcohol can make you more likely to fall.
- Tell your doctor if you have fallen, even if you weren't hurt at your next check-up. A fall can alert your doctor to problems with your eyesight or medications or a new medical condition.

QUESTION
What is another medical term for osteoporosis? See AnswerHealth Solutions From Our Sponsors
Centers for Disease Control and Prevention: "Genomics & Precision Health Osteoporosis."
Memorial Sloan Kettering Cancer Center: "Improving Your Bone Health."
National Institute on Aging: "Prevent Falls and Fractures."
National Osteoporosis Foundation: "BONE BASICS WHO GETS OSTEOPOROSIS."
NIH Osteoporosis and Related Bone Diseases National Resource Center: "Osteoporosis Overview."
Office on Women's Health: "Osteoporosis."
OrthoInfo: "Osteoporosis."
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