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Bones go through a constant state of loss and regrowth. As a person ages, more bone loss than bone growth occurs. This can lead to a condition called osteoporosis. The bones then become thin and fragile and can fracture or break easily.

What Is Osteoporosis?

Bone is made primarily of calcium phosphate and protein. There are two types of bone — compact bone and spongy bone. Each bone in the body contains some of each type. The first signs of osteoporosis are seen in bones that have a lot of spongy bone, such as the spine, hip, and wrist.

Osteoporosis can pose a special threat to women. Estrogen — a female hormone — protects against bone loss. Hormone therapy slows bone loss after menopause. Estrogen has been shown to decrease the risk of hip fractures and spinal deformities. However, bone loss begins to happen long before menopause. Often, by the time symptoms of osteoporosis show, a great deal of bone loss has already occurred. Some symptoms of osteoporosis are back pain or tenderness. Signs include a loss of height more than what is normal for your age group, and a slight curving of the upper back. Osteoporosis affects at least 10 million Americans — most of whom are women.

Risk Factors

Compared with men, women are more at risk of osteoporosis because of menopause and because their bones are smaller and lighter than men’s bones.


It is hard to grow new bone after it is lost, so prevention is important. Slowing bone loss helps build strong bones. To prevent osteoporosis, focus on building and keeping as much bone as you can. This can be done by doing weight-bearing exercises and choosing foods with enough calcium and Vitamin D.


You should have a physical exam once a year during which your height is measured. All women aged 65 years and older or younger women who have had a bone fracture should be tested for bone mineral density no more than every 2 years. Bone mineral density tests measure bone mass in the heel, spine, hip, hand, or wrist. The devices used for the tests vary, but all involve X-rays or beams from other energy sources.


There are many treatment options available to help reduce the risk of fracture. Some need to be taken every day, some are weekly, and some are monthly. There is also an option of getting a yearly injection. No matter what dosing method you choose, the earlier treatment is started, the better it works.


To increase your chances of staying healthy, you have an important goal — to prevent bone loss. Exercise every day, even if you walk only a few blocks, and get enough calcium. Talk with your doctor about methods to prevent, diagnose, and treat osteoporosis.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

Osteoporosis — Prevent Hip Fractures

Hip fractures

As a woman grows older, she needs to be aware of what she can do to maintain her health. After the age of menopause, a woman's bones may lose density (a condition known as osteoporosis) and therefore break more easily.

The National Osteoporosis Foundation has estimated that more than 10 million people in the United States have osteoporosis. An additional 19 million have low bone mass (a condition that places them at increased risk for osteoporosis and fractures). A study in the October 13, 1999, issue of The Journal of the American Medical Association (Harris et al) tested the effectiveness of a particular drug to reduce the risk of fractures in postmenopausal women diagnosed with osteoporosis. The study found that daily doses of the drug were effective in reducing the risk of fractures by about 40 percent over three years and also helped increase bone density. Talk with your doctor about specific ways to prevent osteoporosis and hip fractures.


Fractures and their complications are among the serious consequences of osteoporosis. The most common fractures are those of the hip, spine, and wrist, but hip fractures are considered the most serious. Hip fractures can cause death and disability, with only one-third of the sufferers of hip fractures being able to regain the level of independence they had before their injury. It is best to try to prevent hip fractures from occurring in the first place by taking the necessary precautions.

If You Fall:

If you or someone you know falls and you suspect a fracture, get immediate medical help. All falls, even if minor, should be brought to the attention of your doctor.

To Help Prevent Osteoporosis and Fractures:

  • Consume enough calcium (at least 1,200 mg per day; for example, there is about 300 mg of calcium in a cup of low-fat milk) and vitamin D (between 400 and 800 IU daily for individuals at risk of deficiency; for example, there is 100 IU of vitamin D in one cup of most types of milk).
  • Get regular weight-bearing and muscle-strengthening exercise (such as walking and working with weights or machines that build muscles and bone, both of which decline with age) to reduce the risk of falls and fractures.
  • Avoid smoking and don't drink more than moderate amounts of alcohol. Both are associated with a higher risk of osteoporosis.

Prevent Falls:

Falls can be caused by medications that affect your alertness or balance. Falls can also be caused by poor vision or hearing; impaired muscle strength, coordination, or reflexes; and by diseases that affect balance. Some ways to prevent falls at home and outside include:

  • Remove all loose wires, cords and throw rugs from floors. Make sure all other rugs are anchored and smooth.
  • Install grab bars and non-skid tape or rubber mats in the bathtub or shower and in the kitchen near the sink and stove.
  • Make sure all hand rails on stairways are secure.
  • Make sure the house is well lit. Turn lights on if you get up during the night.
  • Wear sturdy, rubber-soled shoes.


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