Conditions we treat
Osteoporosis is a condition in which bones become thinner, weaker, and more likely to break, sometimes from a minor fall, a bump, or even a strong cough. It is often called a silent disease because bone loss causes no symptoms until a fracture happens. Osteoporosis is not an inevitable part of aging: bone density testing can find it early, and effective treatments can lower fracture risk. Endocrinologists are well placed to help because many causes of bone loss are hormonal.
54 million
Americans have osteoporosis or low bone mass
1 in 2
women age 50 and older will break a bone due to osteoporosis
Up to 1 in 4
men age 50 and older will break a bone due to osteoporosis
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Bone is living tissue that is constantly broken down and rebuilt. Most people reach their peak bone mass in early adulthood; after that, bone breakdown gradually outpaces bone formation. When the loss becomes significant, the inner structure of bone turns porous and fragile.
Hormones play a major role. The drop in estrogen at menopause speeds up bone loss, which is why women are affected most often, and low testosterone can weaken bones in men. Bone density that is lower than normal but not yet in the osteoporosis range is called low bone mass, or osteopenia.
Some risk factors can’t be changed, such as being female, older age, a family history of osteoporosis, and a small, thin frame. Others can be addressed, including smoking, heavy alcohol use, low calcium and vitamin D intake, and inactivity.
Endocrinologists pay special attention to secondary causes, which are often treatable. The NIAMS osteoporosis overview notes that long-term use of certain medicines can make bone loss more likely. Secondary causes include:
Most people have no symptoms until a bone breaks. The first sign is often a fracture of the wrist, hip, or spine after a minor fall. Spinal (vertebral) fractures can cause sudden back pain, but some happen silently and only show up over time as lost height or a stooped posture.
The U.S. Preventive Services Task Force recommends osteoporosis screening for all women 65 and older and for younger postmenopausal women at increased fracture risk. The Bone Health & Osteoporosis Foundation also advises testing for men 70 and older and for anyone who breaks a bone after age 50.
A hip or spine fracture from minor trauma can indicate osteoporosis even when bone density looks better than expected. Your clinician may also use FRAX, a tool that estimates your 10-year probability of a major fracture, to guide treatment decisions.
Bone density is measured with a DXA (dual-energy X-ray absorptiometry) scan, a quick, low-radiation test of the hip and spine. Results are reported as a T-score:
Normal bone density
Low bone mass (osteopenia)
Osteoporosis
Calcium and vitamin D are the foundation. The Bone Health & Osteoporosis Foundation recommends 1,200 mg of calcium daily from all sources for women 51 and older and men 71 and older, and 800 to 1,000 IU of vitamin D for most adults 50 and older. Food comes first, with supplements filling any gap.
For people at high fracture risk, medication can strengthen bone and lower the chance of breaking one:
An injection every six months; stopping it without switching to another medicine can cause rapid bone loss and spine fractures, so it should never be stopped without a plan
Including raloxifene or menopausal hormone therapy, for selected patients
We review your DXA report and, when possible, compare scans done on the same machine over time. We estimate your fracture risk and look for secondary causes with labs such as calcium, vitamin D, parathyroid hormone, kidney function, thyroid tests, and testosterone for men when appropriate.
Your endocrinologist then matches treatment to your risk level, health history, and preferences, discusses possible side effects, and plans the long-term sequence, including when a break from bisphosphonates (a drug holiday) may be reasonable. We coordinate with your primary care doctor, dentist, and orthopedic team. Schedule a bone health visit in person or virtually.
Osteoporosis is usually a long-term condition, but treatment can make a real difference. Medications can slow bone loss, and bone-building treatments can increase bone density. The main goal is to lower your risk of fractures. Combined with calcium, vitamin D, exercise, and fall prevention, treatment can help stabilize or improve bone density over time.
It depends on your results and treatment. People starting or changing osteoporosis medication often have a follow-up DXA scan after one to two years, while those with normal or mildly low bone density may be retested less often. For accurate comparisons, it’s best to repeat scans on the same machine whenever possible.
Food should come first. If your diet falls short, supplements can help you reach recommended amounts, such as 1,200 mg of calcium daily for women over 50. More isn’t better: too much calcium from supplements can raise the risk of kidney stones. Your clinician can check your vitamin D level and recommend the right dose for you.
Most people tolerate them well. Rare but serious side effects, such as osteonecrosis of the jaw and unusual thigh bone fractures, have been linked to long-term use of some medicines. For people at high risk of fracture, the benefit of preventing broken bones generally outweighs these risks. Your endocrinologist will review your history, dental health, and kidney function before choosing treatment.
Yes. According to the Bone Health & Osteoporosis Foundation, up to one in four men age 50 and older will break a bone due to osteoporosis. Men are more likely to have a secondary cause, such as low testosterone, long-term steroid use, or heavy alcohol use, so an endocrine evaluation can be especially helpful.
Last reviewed September 19, 2026. This page is educational and is not a substitute for personal medical advice — see our medical disclaimer.
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