• Bone Density Peak: Ladies, your bones hit their strongest at 19 years old!
• Bones Get Weaker Over Time: Especially after menopause, making them more fragile and prone to fractures.

• T-Score: Compares your bone strength to a healthy 30-35 y/o woman. Used if you’re 40+ years old.
• Z-Score: Compares your bones to people your own age. Used if you’re under 40. If it’s less than -2, more tests are needed!

Biggest Risk Factors:
Age (older = higher risk)
History of a Fragility Fracture (like breaking a bone from a small fall)
Low Bone Density (BMD)

Other Risk Factors:
Smoking, too much alcohol, long-term steroid use, low weight, rheumatoid arthritis, early menopause, and family history of hip fractures.

This tool predicts your 10-year fracture risk based on your age, weight, medical history, and lifestyle.

• Treatment needed if:
  • Hip fracture risk > 3%
  • Major fracture risk > 20%
• Who should use FRAX? Women 40+ who are postmenopausal and not already on osteoporosis treatment.

All women 65+ should get a DEXA scan!
If < 65, get a scan if you have risk factors like:

• Low weight (<127 lbs)
• Fragility fracture history
• Family history of hip fractures
• Smoking, heavy alcohol use, RA, or medical conditions that weaken bones

• Normal Bone Density: T-score above -1 → Repeat scan in 15 years
• Osteopenia (Mild Bone Loss): T-score -1 to -2.49
  • Repeat scan in 5 years (if -1.5 to -1.99)
  • Repeat in 1 year (if -2 to -2.49)
• Osteoporosis (Severe Bone Loss): T-score below -2.5
  • Repeat scan in 2 years after starting treatment

• Calcium & Vitamin D: Keep those bones strong!
  • Calcium Needs:
    • 1,300mg/day (age 9-18)
    • 1,000mg/day (age 19-50, pregnancy, lactation)
    • 1,200mg/day (age 51+)
  • Vitamin D Needs:
    • 600 IU/day (under 70)
    • 800 IU/day (over 70)
    • Upper safe limit: 4,000 IU/day
• Exercise: Weight-bearing and strength training!
• Quit smoking & limit alcohol
• Fall-proof your home: Secure rugs, install grab bars, and keep floors clutter-free

• First-Line Treatment: Bisphosphonates (-dronate drugs like Alendronate, Zoledronic acid)

   

  • Reduce bone breakdown
  • Take on an empty stomach, stay upright for 30 min (to avoid stomach issues)

  Other Medications:

  • SERMs (Raloxifene): Protects bones, also reduces breast cancer risk, but increases clot risk 
  • Denosumab (Prolia): Given if high fracture risk or can’t take bisphosphonates
  • Anabolic Agents (-paratide drugs like Teriparatide): Build new bone, used for severe cases
  • Romosozumab: A newer option for severe osteoporosis

• Get a DEXA scan at 65+ (or earlier if high risk)
• Prevent fractures with diet, exercise, and fall-proofing
• If needed, treat with meds to strengthen bones
• Know your FRAX score & risk factors!

STRONG BONES, STRONG LIFE!