• Risk Factors for Osteoporosis

    A risk factor is something that increases your likelihood of getting a disease or condition. It is possible to develop osteoporosis with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing osteoporosis. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.

    Risk Factors for Women

    Women are at greater risk of developing osteoporosis than men. This is because they have less bone tissue than men and have a sudden drop in hormones—especially estrogen—at menopause .
    Estrogen Deficiencies
    Estrogen deficiencies occur as a result of:
    • Menopause—Natural or surgical menopause increases your risk of osteoporosis. The risk of fracture increases significantly after menopause.
    • Amenorrhea (cessation of menstruation before menopause)—Your risk of osteoporosis increases if you miss menstrual periods for three months or longer. Amenorrhea may occur with eating disorders, such as anorexia nervosa and bulimia , or with excessive or intensive exercise, such as long distance running.

    Risk Factors for Men

    Men have a higher bone density and lose calcium at a slower rate than women. However, after age 50, bone loss gradually increases. Risk factors for bone loss in men include:
    Hormonal Deficiencies
    In men, deficiencies of testosterone and, to a much minor extent, estrogen play a role in the development of osteoporosis. This may be related to:
    • Advanced age
    • Treatment for prostate cancer , which lowers testosterone levels
    • Hypogonadism, a severe deficiency in the male sex hormone

    Risk Factors in Both Sexes

    Having a family history of osteoporosis, especially hip fracture, puts you at a higher risk. Genetic diseases, such as cystic fibrosis, glycogen storage diseases, or homocystinuria also play a role in higher osteoporosis risk.
    Dietary Factors
    Your risk of developing osteoporosis increases if you have a restrictive diet, such as not getting enough calcium or vitamin D . An excess of phosphorous in your diet may increase your risk if your calcium and/or vitamin D intakes are low. Excessive use of alcohol , coffee, or tea may also increase your risk of osteoporosis.
    Lack of Exercise
    Regular exercise , especially weight-bearing and resistance exercise, helps strengthen bones. Therefore, if you do not exercise on a regular basis, you may increase your risk of developing osteoporosis. Individuals who do not exercise regularly also tend to have weaker muscles and poorer balance, which can lead to falls and fractures.
    Smoking impairs bone, muscle, and joint health. If you smoke, you have a higher risk of developing osteoporosis.
    Bone Structure and Body Weight
    Small-boned women and underweight people of both sexes have an increased risk of osteoporosis.
    Lack of Sunlight
    The effect of sun on the skin is a primary source of vitamin D, which aids bone formation. If you get very little sun exposure and have a low dietary intake of vitamin D, you may be at increased risk of osteoporosis.
    Ethnic Background
    Caucasian, Asian, and Hispanic women are more likely to develop osteoporosis than those of other ethnic groups. Though most ethnic studies have focused on women, it is believed that men in these ethnic groups carry a parallel but lower risk.
    The long-term use of certain medications increases your risk of osteoporosis. Examples include:
    • Corticosteroids
    • Medications to suppress the immune system
    • Chemotherapy
    • Gonadotropin-releasing hormone
    • Antidepressants
    • Antiseizure medications
    • Medications containing aluminum, such as antacids
    • Proton pump inhibitors
    • Long-term heparin therapy
    • Glitazones, medications to treat diabetes
    Talk to your doctor before stopping or reducing your medications.
    Chronic Diseases
    Certain chronic conditions may increase your risk for developing osteoporosis.
    Gastrointestinal conditions include:
    Endocrine or hormonal conditions include:
    Other disorders include:


    Diseases and conditions that may cause bone loss. National Osteoporosis Foundation website. Available at http://www.nof.org/articles/5. Accessed July 16, 2013.

    Ho-Pham LT, Nguyen ND, Nguyen TV. Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis. Am J Clin Nutr. 2009;90:943-950.

    Medicines that may cause bone loss. National Osteoporosis Foundation website. Available at http://www.nof.org/articles/6. Accessed July 16, 2013.

    Osteoporosis. NIH Osteoporosis and Related Bone Diseases National Resource Center website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bone/Osteoporosis/default.asp. Accessed July 16, 2013.

    Osteoporosis causes and risk factors. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 4, 2013. Accessed July 16, 2013.

    The man's guide to osteoporosis. National Osteoporosis Foundation website. Available at http://www.nof.org/files/nof/public/content/file/252/upload/85.pdf. Accessed July 16, 2013.

    What women need to know. National Osteoporosis Foundation website. Available at: http://www.nof.org/articles/235. Accessed July 16, 2013.

    1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Loke YK, Singh S, et al. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-39.

    1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Carbone LD, Johnson KC, et al. Loop diuretic use and fracture in postmenopausal women: findings from the Women's Health Initiative. Arch Intern Med. 2009;169:132-140.

    12/29/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Hippisley-Cox J, Coupland C. Predicting risk of osteoporotic fracture in men and women in England and Wales: prospective derivation and validation of QFractureScores. BMJ. 2009;339:b4229.

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