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Osteoporosis is a condition that affects your bones. It makes some bones, such as your hips and spine, weak and more likely to break.

About 10 million Americans have osteoporosis. Another 34 million are at risk of getting it. Of people at risk, 4 out of 5 are women. Half of all American women over 50 will have a broken bone caused by osteoporosis during their life.¹

You may not even know you have osteoporosis until a bone breaks more easily than you might expect, especially a bone in your spine, wrist or hip. Osteoporosis can also cause the bones in your spine to collapse, giving you a curved spine or hunched back.

Broken bones can be painful. If you fracture your hip, for example, you may need major surgery. You may end up unable to live at home or look after yourself.

You may think of your bones as solid. But bone is constantly going through two processes. Old bone breaks down, and new bone grows to replace it.² You get osteoporosis when more bone is broken down than new bone grows. Gradually, the bones become less solid and your whole skeleton becomes weaker.

Bones naturally become thinner as you get older, whether you are a man or woman. But at the time of menopause, some women start to lose bone a lot faster. This is because their bodies are making less of the hormone estrogen. To find out more, see Estrogen: its special role.

Many other things can put you at risk of having weak bones when you get older. They include smoking, not eating well and not getting enough exercise. You may also be at risk if your mother had osteoporosis or if your diet was poor when you were a child.

But there are things you can do that may reduce your risk of getting weak bones. Here are some suggestions.

• Eat foods rich in calcium. Calcium is a mineral that helps prevent bone loss. If you are a woman over 50 and you are not taking estrogen through hormone replacement therapy (HRT), you should be consuming 1,200 milligrams (mg) of calcium daily.¹ If you are using HRT, you should be taking 1,000 mg. Calcium is found in dairy products such as milk and cheese.
• Get enough vitamin D. This vitamin works with calcium to preserve bone strength. You get it mainly from sunlight, so make sure you get at least 20 minutes of sunlight a day or take a calcium and vitamin D supplement. If you are over 50, you should be getting 400 international units (IU) of vitamin D daily. This is the amount in most multivitamins.
• Do regular weight-bearing exercise. This is exercise that puts your bones under pressure, such as walking briskly, jogging or weightlifting. There are lots of studies that show that exercise in women over 50 helps to prevent bone loss.² Thirty minutes of exercise three times a week is recommended.
• Take a drug to prevent bone loss. There are several of these available. Ask your doctor for information.

If you think you are at high risk of osteoporosis (if, for example, your mother had a hip fracture), you can ask your doctor for a bone-mineral density test. This is a test that uses a weak X-ray to measure how strong your bones are for your age. It call tell you whether you're at risk of getting osteoporosis.

If you are at risk of osteoporosis, you might consider taking HRT, which contains the hormone estrogen. There's good evidence that HRT can help prevent osteoporosis and stop you from getting fractures.³ To learn more, see HRT.

But you have to take HRT for a long time to keep your bones strong.⁴ And taking HRT has risks. It slightly increases your chances of having a stroke and of getting breast cancer, heart disease and a blood clot in your lungs.⁴ Because of the risks, your doctor may discuss other treatments to prevent bone loss, rather than offering HRT as a first choice.

To read more, see our information on Osteoporosis.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.