Osteopenia is a loss of bone mineral density (BMD) that weakens bones. It’s more common in people older than 50, especially women. Osteopenia has no signs or symptoms, but a painless screening test can measure bone strength. Certain lifestyle changes can help you preserve bone density and prevent osteoporosis.


What is osteopenia?

Osteopenia is a loss of bone mineral density (BMD). Lower BMD indicates you have fewer minerals in your bones than you should, which makes bones weaker.


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What’s the difference between osteopenia and osteoporosis?

Osteopenia isn’t as severe as osteoporosis, a disease that weakens bones so much that they can break more easily. Not everyone with osteopenia develops osteoporosis, but it can happen. People with osteopenia should try to strengthen and protect their bones. And their healthcare providers should monitor their bone mineral density.

How common is osteopenia?

Osteopenia is a common condition, affecting about 34 million Americans. It’s especially common among:

  • All people older than 50 years.
  • People with poor nutrition.
  • Women after menopause.

Symptoms and Causes

What causes osteopenia?

Bones are made of living tissue. Up until about age 30, a healthy person builds more bone than he or she loses. But after age 35, bones begin to break down faster than they build up. Even in a healthy person, bone density decreases throughout life, by less than 1 percent per year.

Some things can make bone loss happen more quickly, leading to osteopenia, such as:

  • Medical conditions such as hyperthyroidism.
  • Medications such as prednisone and some treatments for cancer, heartburn, high blood pressure and seizures.
  • Hormonal changes during menopause.
  • Poor nutrition, especially a diet too low in calcium or vitamin D.
  • Surgery on the gastrointestinal system, which can affect the body’s ability to absorb needed nutrients and minerals.
  • Unhealthy lifestyle choices, such as smoking, drinking too much alcohol or caffeine, and not exercising.

What are the symptoms of osteopenia?

Osteopenia usually doesn’t cause any signs or symptoms until it progresses to osteoporosis. Rarely, some people with osteopenia may experience bone pain or weakness. The condition is usually detected when a person has a BMD screening.


Diagnosis and Tests

How is bone loss diagnosed?

To diagnose low bone mineral density, a healthcare provider will:

  • Ask questions about your family’s medical history, particularly osteoporosis.
  • Ask questions about your personal medical history, including medications you’ve taken, medical conditions you’ve had, lifestyle choices you’ve made, etc.
  • Conduct a physical examination.
  • Order a bone density test.

Bone density is measured with dual-energy X-ray absorptiometry (DEXA). DEXA is a quick and painless imaging test that uses X-rays to determine whether you have healthy bones, osteopenia or osteoporosis. It provides a score called a T-score:

  • +1 to –1 indicates normal bone density.
  • –1 to –2.5 indicates osteopenia.
  • –2.5 or lower means osteoporosis.

DEXA gives healthcare providers a “baseline measurement.” That means they can compare the current test results to future results to determine whether bone density decreases over time.

Management and Treatment

How are osteopenic bones treated?

There’s no cure for osteopenia, but it’s important to preserve bone density as much as possible. Treatment involves simple strategies to keep your bones as healthy and strong as possible and prevent progression to osteoporosis:

Your healthcare provider will also want to monitor your bone density over time in case you develop osteoporosis.


What can I do to prevent bone loss?

Several strategies can help you maintain bone strength and prevent bone loss:

  • Avoid smoking.
  • Eat a healthy, balanced diet with lots of fruits, vegetables, calcium and vitamins.
  • Exercise every day. Walking, jogging and other activities that make you bear your own weight are particularly helpful, as is weight training.
  • Get at least 1,200 mg of calcium daily.
  • Get at least 800 to 1,000 IU of vitamin D daily.
  • Go outside for exposure to the sun, which helps your body absorb vitamin D into the bloodstream.
  • Limit alcohol.

Outlook / Prognosis

What is the outlook for people with osteopenia?

If you’re diagnosed with osteopenia, you will need regular bone density tests to monitor bone health, usually every two to three years.

Not everyone with osteopenia develops osteoporosis. Changes to your lifestyle can keep bone loss to a minimum. For those who do develop osteoporosis, some treatments can help protect and strengthen the bones.

Living With

How do I take care of myself with osteopenia?

Falls are the leading cause of fractures in people with low bone density. Besides making healthy lifestyle choices to maintain bone density, it’s important to prevent falls. Precautions may include:

  • Make sure your home has ample lighting.
  • Put railings on stairs and in showers.
  • Remove any tripping hazards (for example, small furniture, rugs that turn up at the corners, items that are out of place).
  • Treat slippery surfaces immediately, such as spills, ice and snow.
  • Use nonskid rugs on floors.

When should I talk to my healthcare provider about bone density?

Talk to your healthcare provider about a bone density test if you:

  • Fracture a bone, especially doing something that might not normally be expected to cause serious injury.
  • Have bone pain.
  • Have risk factors for bone loss.

A note from Cleveland Clinic

Osteopenia is a loss of bone mineral density (BMD). The condition doesn’t usually have any signs or symptoms until it progresses to osteoporosis. If you have any risk factors for osteopenia, talk to your doctor about screening for low BMD. Lifestyle choices and some treatments can help slow bone loss.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 09/29/2021.

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