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Risk Factors for Osteoporosis
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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 five years after menopause. Though initial fractures may be in the wrist or spine, these strongly predict the later development of severe osteoporosis and hip fracture.
- 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.
Other Risk Factors
These are some other risk factors may increase a woman's risk of developing osteoporosis:
- Family history of osteoporosis
- Gastrointestinal malabsorption
- Having another endocrine disorder (eg, thyroid disorder, diabetes)
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
- Certain conditions that reduce testosterone levels (eg, mumps, treatment for prostate cancer)
- Hypogonadism (a severe deficiency in the male sex hormone)
Risk Factors in Both Sexes
Dietary Factors
Your risk of developing osteoporosis increases if you have a restrictive diet (eg, 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
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. Individuals who are short, thin, and have narrow hips are at increased risk of low bone density and fracture.
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.
Medications
The long-term use of certain medicines increases your risk of osteoporosis. Examples include:
- Corticosteroids
- Medicines to suppress the immune system
- Chemotherapy
- Thyroid medicines
- Antidepressants (eg, tricyclic antidepressants, selective serotonin reuptake inhibitors)
- Antiseizure medicines
- Medicines containing aluminum (eg, certain antacids)
- Long-term heparin therapy
- Glitazones (diabetes medicine)
Talk to your doctor before stopping or reducing your medicine.
Chronic Diseases
Certain chronic diseases may increase your risk for developing osteoporosis.
- Cardiovascular disease
- Asthma
- Liver disease (eg, cirrhosis)
- Kidney disease
- Rheumatoid arthritis
- Type 2 diabetes
- Hyperthyroidism
- Hyperparathyroidism
- Cushing’s syndrome
- Sarcoidosis
- Scurvy (vitamin C deficiency)
- Gastrointestinal disorders, especially those causing malabsorption
- Eating disorder
- Alcoholism
- Depression (possibly be due to higher levels of the stress hormone cortisol, which may contribute to loss of bone density)
- Inherited disorders (eg, Marfan syndrome, Ehler-Danlos syndrome, porphyria)
- Cancer (eg, lymphoma, leukemia, myeloma)
- Treatment for cancer (eg, chemotherapy, radiation therapy)
- Organ transplant
- Crohn's disease
Diseases During Childhood
If you had certain conditions during childhood, you may be at an increased risk for developing osteoporosis later in life. Examples of these conditions include:
- Premature birth
- Anorexia nervosa
- Asthma or other diseases that are treated with corticosteroids
- Disorders that cause malabsorption (eg, cystic fibrosis, inflammatory bowel disease, celiac disease)
- Conditions that cause low hormone levels (eg, delayed puberty, delayed onset of periods in girls, infrequent or no periods in girls)
References:
Last reviewed September 2010 by Marcin Chwistek, MD
Last Updated: 9/20/2010
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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