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Osteopenia vs. Osteoporosis: Is One More Concerning Than The Other?

Medically reviewed by January Velasco, MD · General Practitioner

Written by Lorraine Bunag, R.N. · Updated Jul 18, 2022

Osteopenia vs. Osteoporosis: Is One More Concerning Than The Other?

Chances are, you are familiar with osteoporosis, a condition where bones lose their density and strength, making them more vulnerable to fractures. However, have you heard about a closely related condition called osteopenia? Here’s what you need to know about osteopenia vs. osteoporosis. 

Bone Density Test and T-Scores

To fully appreciate the topic, osteopenia vs. osteoporosis, you need to have some knowledge about the bone density test and T-scores. 

A bone mineral density (BMD) test (or simply bone density test) measures the amount of minerals contained in a certain volume of bone. The most common way to do this is via the central dual-energy x-ray absorptiometry or central DXA test. 

The DXA test is a painless procedure; it’s just like having a regular x-ray. Results come as T-scores, which basically compare your bone mass to that of a healthy young adult. 

A T-score of 0 means your bone mass is equal to the expected bone mass of a healthy young adult. The lower your score is (below zero, presented in negative numbers), the lower your bone mineral density is. This also means you are more at risk of fractures. 

NOTE: A bone mineral density test is typically recommended for women approaching menopause or those aged 65 and older. In some cases, they also recommend it to men aged 70 and up.  

Osteopenia vs. Osteoporosis: Definition

Now that you have a better understanding of bone mass and T-scores, let’s talk about the definitions of osteoporosis and osteopenia. 

Having a T-score of -1 or +1 is normal. That means your bone density is comparable to that of a healthy young adult. 

According to the World Health Organization, osteopenia occurs when your T-score is anywhere between -1 and -2.5. On the other hand, osteoporosis indicates a T-score of -2.5 or lower. 

Generally, osteopenia describes a decrease in bone mass below the normal reference values, yet it’s not low enough to be considered osteoporosis. 

Osteopenia vs Osteoporosis: Which is More Worrying? 

If you have osteopenia, it generally means your bones are not as strong as they should be, but the mineral loss is not causing problems yet. When you have osteoporosis, your bones are weak and they may break with slight injuries.  

But does that mean osteoporosis is more worrying? 

Not necessarily. 

According to experts, osteopenia can progress into osteoporosis. To stave off the possibility, patients must take steps to preserve and promote their bone mass and strength. 

Causes and Risk Factors

Discussing the topic, osteopenia vs. osteoporosis, will not be complete without talking about their causes and risk factors. 

Because these two conditions are closely related, their causes and risk factors are the same. 

Reports say the cause of primary osteopenia and osteoporosis is the gradual, natural bone loss associated with aging (and menopause in women). Secondary causes include:

  • Lifestyle factors, such as lack of physical activity, excessive alcohol consumption, and smoking. 
  • Health conditions, like hyperthyroidism, malabsorption syndrome, and anorexia
  • Certain medicines, such as antiepileptics, long-term steroid use, and chemotherapy drugs. 

Osteopenia vs. Osteoporosis: Prevention and Treatment

In many cases, doctors do not prescribe medicines to osteopenic patients unless they have a high risk of experiencing fractures in the next ten years. 

Generally, the goal of osteopenia treatment is to prevent further bone mass loss and progress into osteoporosis. You can do this by:

  • Performing regular, appropriate exercise routines
  • Getting adequate vitamins and minerals for the bones, preferably through a healthy and balanced diet. 
  • Quitting smoking
  • Limiting alcohol intake
  • Actively taking steps to prevent falls and other accidents

Of course, these are best achieved under the guidance of a healthcare professional. 

Key Takeaways

Osteopenia vs. osteoporosis is not a common topic of discussion. Mostly, people are familiar with osteoporosis but are not aware of osteopenia. 

Osteopenia means your bones have lower mass, but it’s not low enough to be considered osteoporosis. Still, because osteopenia can progress into osteoporosis, it’s crucial that you actively take steps to prevent further bone loss.

Worried about osteoporosis? Try our Osteoporosis Risk Screener here


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

January Velasco, MD

General Practitioner

Written by Lorraine Bunag, R.N. · Updated Jul 18, 2022

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