Osteoporosis: Symptoms, Causes, DEXA Screening, and Treatment — What Your Doctor Wants You to Know in 2026

Written by Dr. Kathryn Kline, MD, Board-Certified Family Medicine Physician | Medically reviewed by Dr. Casey Dean, DO | Trinity Family Medicine

Last medically reviewed: July 2026

Osteoporosis is a disease that gradually weakens bones and makes them more likely to break, especially in the hip, spine, and wrist. Because bone loss causes no symptoms until a fracture happens, osteoporosis is often called a "silent disease." A DEXA scan diagnoses it, and treatment includes exercise, calcium, vitamin D, and medication when appropriate.

Osteoporosis is called a "silent disease" for a reason: it quietly weakens your bones for years without a single symptom, and for many people the first sign is a broken bone. In the United States, roughly 1 in 10 adults age 50 and older — about 10 million people — have osteoporosis, and nearly 1 in 5 women over 50 are affected.

Even more striking, a woman's lifetime risk of suffering a major osteoporosis-related fracture (hip, spine, wrist, or upper arm) is close to 1 in 2. Yet osteoporosis is one of the most preventable and treatable conditions in all of medicine. The problem is that far too many people never get their bones checked until after they break one.

This guide explains what osteoporosis is, its symptoms and causes, who should be screened, and how osteoporosis is treated — much of which can now be handled through a telehealth visit from home.

Key statistic: Nearly 1 in 2 women over age 50 will break a bone because of osteoporosis at some point in their lifetime.

Quick Summary: Key Facts at a Glance

What Is Osteoporosis?

Your bones are living tissue. Throughout life, your body constantly breaks down old bone and builds new bone in its place — a process called remodeling. In your youth, you build more than you lose, reaching peak bone mass around age 30. After that, the balance slowly tips the other way.

Osteoporosis (literally "porous bone") is what happens when bone loss outpaces bone formation to the point that your skeleton becomes fragile and prone to breaking. Under a microscope, healthy bone looks like a dense honeycomb. Osteoporotic bone has much larger holes and thinner walls — the same architecture, but weaker and more brittle.

There is also an earlier, milder stage called osteopenia, which means your bone density is lower than normal but not yet in the osteoporosis range. Think of osteopenia as the yellow warning light on your dashboard: it's your window of opportunity to act before a fracture ever happens.

What Are the Symptoms of Osteoporosis?

Here is the clinical insight that surprises most patients: osteoporosis causes no pain, no stiffness, and no symptoms while your bones are thinning. You cannot feel your bone density dropping. Unlike a pulled muscle or an infection, there is nothing to alert you.

The first noticeable sign is often a fragility fracture — a broken bone from a fall, bump, or force that would never break a healthy bone. Common examples include breaking a wrist catching yourself on a countertop, or fracturing a bone in your spine simply from bending, lifting a grocery bag, or coughing hard.

Over time, small spinal (vertebral) fractures can stack up and produce the visible clues people associate with aging: losing height, a forward-curved upper back (sometimes called a "dowager's hump"), and chronic back pain. If you've noticed you're more than an inch or two shorter than you were at your tallest, that is worth mentioning to your doctor — it can be a sign of undetected spinal fractures. (For more, see our guide to low back pain: causes, symptoms, and treatment.)

What Causes Osteoporosis and Who Is at Risk?

Osteoporosis can affect anyone, but certain factors raise your risk substantially:

Men get osteoporosis too. While about 2 million American men have osteoporosis, it's frequently overlooked in them — and men actually have a higher risk of dying after a hip fracture than women do.

How Is Osteoporosis Diagnosed?

Because you can't feel it, screening is the only way to catch osteoporosis before a fracture. The standard test is a DEXA scan (dual-energy X-ray absorptiometry) — a quick, painless, low-radiation scan, usually of your hip and spine, that measures your bone mineral density (BMD).

Your result is reported as a T-score, which compares your bone density to that of a healthy young adult:

Osteoporosis can also be diagnosed regardless of T-score if you've already had a fragility fracture of the hip or spine. Your doctor may also use the FRAX® fracture risk calculator alongside your DEXA results to estimate your 10-year risk of a major osteoporotic fracture, and may order blood work to check calcium, vitamin D, thyroid, and other factors that can quietly weaken bones.

Who Should Be Screened?

According to the 2025 U.S. Preventive Services Task Force (USPSTF) recommendation, all women 65 and older should be screened for osteoporosis with a bone density test. The Task Force also recommends screening postmenopausal women younger than 65 who are at increased risk of fracture based on factors like low body weight, smoking, family history, or steroid use.

The 2025 update kept the same overall structure as the prior 2018 version but refined how younger postmenopausal women are identified — moving away from a single rigid risk-score cutoff toward a broader clinical risk assessment to decide who should proceed to a DEXA scan. There is not yet a formal USPSTF recommendation for routine screening in men, but many experts screen men over 70, or younger men with clear risk factors.

How Is Osteoporosis Treated?

The good news is that osteoporosis is very treatable, and the goal is simple: keep your bones strong enough to avoid a fracture. Treatment combines lifestyle foundations with medication when needed.

Nutrition

Aim for at least 1,200 mg of calcium and 800–1,000 IU of vitamin D per day, ideally from food first (dairy, leafy greens, fortified foods, fatty fish) and supplements to fill the gap. Vitamin D is what allows your body to absorb the calcium you eat.

Exercise

Weight-bearing activities (walking, dancing, stair climbing) and resistance/strength training signal your bones to stay strong, while balance work like tai chi reduces the risk of falling in the first place.

Fall Prevention

Since most fractures happen during falls, small changes matter: removing loose rugs, improving lighting, adding grab bars, checking vision, and reviewing medications that cause dizziness.

Medication

For people with osteoporosis or high fracture risk, bisphosphonates such as alendronate, risedronate, or zoledronic acid are first-line therapy — they slow the breakdown of bone and have decades of evidence behind them. Other options include denosumab (an injection), and for very high-risk patients, bone-building "anabolic" medications like romosozumab or teriparatide. Your doctor will match the medication to your risk level, other health conditions, and preferences.

Can osteoporosis be prevented? While osteoporosis can't always be prevented, regular weight-bearing exercise, adequate calcium and vitamin D, not smoking, limiting alcohol, and early screening can substantially reduce your risk of fractures.

A Note for Texans

Despite abundant sunshine, vitamin D deficiency remains common in Texas — and low vitamin D quietly undermines bone health. Extreme summer heat keeps many Texans indoors during peak daylight hours, sunscreen (rightly used to prevent skin cancer) blocks vitamin D production, and darker skin tones make vitamin D more slowly. Checking your vitamin D level is a simple way to identify a common, treatable risk factor for osteoporosis — and it's easy to arrange through a telehealth visit.

When to See Your Doctor

You don't need to wait for a broken bone to think about your bones. Talk to a doctor if you:

At Trinity Family Medicine, we make this easy. Our board-certified physicians can review your risk factors, order a DEXA scan and the right lab work, and interpret your results. From there, they can start or manage treatment — all through a secure telehealth visit from anywhere in Texas*, starting at $49.99.

Bone health is closely linked to the hormonal changes after menopause, making this a good time to discuss both osteoporosis prevention and menopausal symptoms with your physician. (See our guide to menopause symptoms and hormone therapy.) You can book at trinitymedtx.com or call 817-932-4022.

Frequently Asked Questions

Key Takeaways

The Bottom Line

Osteoporosis is a silent, common, and dangerous disease — but it's also one of the most preventable and treatable conditions in medicine. Because it causes no symptoms until a bone breaks, the single most important step you can take is getting screened with a DEXA scan at the right time: age 65 for all women, earlier if you have risk factors. With timely diagnosis, adequate calcium and vitamin D, weight-bearing exercise, fall prevention, and first-line medications when needed, most people can keep their bones strong and avoid the fractures that so often steal independence later in life.

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