What are the risk factors for developing osteoporosis?

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Last updated: May 10, 2025View editorial policy

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From the Guidelines

Ten risk factors for developing osteoporosis include advanced age, female gender, family history of osteoporosis, low body weight, certain medications, smoking, excessive alcohol consumption, inadequate calcium and vitamin D intake, sedentary lifestyle, and certain medical conditions. These risk factors are identified based on the most recent and highest quality study available, which is the 2019 study published in the Journal of Clinical Oncology 1. The risk factors can be broken down into the following categories:

  • Demographic factors:
    • Advanced age (especially over 65)
    • Female gender (particularly postmenopausal women)
  • Medical history:
    • Family history of osteoporosis
    • Previous fragility fracture
  • Lifestyle factors:
    • Smoking
    • Excessive alcohol consumption
    • Sedentary lifestyle
  • Nutritional factors:
    • Inadequate calcium and vitamin D intake
  • Medications:
    • Certain medications (such as long-term corticosteroids, some anticonvulsants, and aromatase inhibitors) These factors contribute to osteoporosis through various mechanisms, including age-related bone loss, genetic predisposition, and interference with bone formation and mineralization. Understanding these risk factors can help identify individuals who may benefit from earlier screening and preventive measures, as recommended by the American College of Physicians 1 and the American Society of Clinical Oncology 1. It is essential to consider these risk factors in the context of real-life clinical medicine to prioritize morbidity, mortality, and quality of life as the outcome, and to make informed decisions about screening, prevention, and treatment of osteoporosis.

From the Research

Risk Factors for Osteoporosis

The following are ten risk factors for developing osteoporosis:

  • Advanced age 2
  • Genetics 2
  • Smoking 2
  • Thinness 2
  • Estrogen deficiency 2, 3, 4, 5
  • Excessive glucocorticoid usage 3
  • Low bone density 2, 3
  • Previous fractures 2
  • Hormonal changes, such as decline of testosterone, Insulin-like growth factor 1 (IGF1), and vitamin D, and the rise of cortisol, parathyroid hormone, and follicle-stimulating hormone (FSH) 4
  • Poor nutrition, including inadequate intake of protein, calcium, and vitamin D 2, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Estrogen therapy for osteoporosis in the modern era.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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