When is osteopenia something to worry about?

When your doctor tells you that you have osteopenia, it can be scary — and a major reason why that’s true is that conventional doctors tend to leave out big chunks of key information about what osteopenia really is and what it means for your bone health. 

What is osteopenia?

Osteopenia is not, and was never meant to be, a true diagnosis, nor is it a disease. Osteopenia is simply a way to describe a state of relatively lower bone mass. “Osteopenia” as we know it is a term that osteoporosis researchers redefined in 1994 to classify a person whose bone density was somewhat lower than the “normal” bone density. Normal bone density, they decided, was  that of the average 30-year-old of the same sex. 

Many women may have osteopenia for most or all of their lives and never even realize it. That’s because — and the science is clear about this — having osteopenia does not predict whether you’ll have a bone fracture.  

4 questions to ask yourself when you have osteopenia

I firmly reject the “great osteopenia scare” that pushes women into looking at osteopenia as a “disease” to be treated with bone drugs, without much further thought or discussion. Women need better, more complete and more accurate information about their bone health. But even partial knowledge is useful if it inspires you to dig deeper to truly understand the needs of your bones. 

To contemplate what osteopenia might mean — or not mean — for your health, ask yourself the following questions. Your answers can help you begin to distinguish a harmless finding of osteopenia from an actual red flag that warrants further investigation.  

Are you entering or in menopause? The average woman loses 10% of her bone mass between the first few years before and the first five years after her last period. Some women lose up to 20% in the menopause transition. Starting this transition with lower-than-normal bone mass (osteopenia) is a signal that you need to prioritize maintaining and rebuilding your bones during and after menopause to reduce your risk of fracture. 

Do you have a family history of hip fracture? When osteopenia is found in someone whose parent(s) have experienced a hip fracture, this may be an early warning sign of future bone fragility. If hip fracture is part your family history, further testing can help you find out if you are losing bone — and how rapidly. 

Have you ever experienced a low-trauma fracture? If you have osteopenia and have already experienced a low-trauma fracture, this is documented bone weakness and a sign that you need to place more attention on implementing a bone-building lifestyle and nutrition program. (And if you also answered “yes” to the family history question, it’s even more imperative that you dig deeper!)

Do your bone scans reveal rapid and excessive bone loss? Because bone loss is common in women in perimenopause and menopause, finding “osteopenia” in a single bone scan may mean very little; the real concern is if subsequent scans reveal rapid and excessive bone loss beyond what’s usual during menopause. If you’re losing more than, say, 2% per year during and immediately after menopause (or more than 1% per year if you’re more than five years post menopause), then you may be on your way to osteoporosis. (But we know lots of ways to decrease bone loss.) 

You are invited to empower yourself! 

If you’ve been told you have osteopenia, I encourage you to join me in my upcoming on-line course, Moving Beyond Osteopenia. I have developed this course to empower each of you with a deeper understanding of osteopenia, what it might mean for you and how to make truly informed decisions about your bone health. 

This dynamic, information-packed course  comes with a live Q&A session with me where I answer your questions and comment on your concerns. 

 Join us as we dive deeper and find out exactly what it takes to build stronger bones for life.