What’s worse, osteopenia or osteoporosis?


Osteoporosis is a condition where bones become weak. This can cause painful fractures and even death. Osteopenia, on the other hand, is a pre-osteoporosis condition that causes low bone mineral density. It’s not as serious as osteoporosis but requires treatment to prevent further damage.

What's worse, osteopenia or osteoporosis?

This post will explore what’s worse, osteopenia or osteoporosis. So you can decide if you need treatment for osteopenia or osteoporosis.

What are the differences between Osteopenia and Osteoporosis? 

The main difference between osteopenia and osteoporosis is the bone mineral density (BMD) of your bones. Osteopenia is a condition where your BMD is lower than normal but not low enough to be considered osteoporosis.

Osteopenia can be a precursor to osteoporosis, so if you have dysplasia, it’s important to get treatment immediately.

Who’s at risk for osteopenia and osteoporosis?

Several factors increase your risk for osteopenia and osteoporosis.

  • Women are more likely to develop osteoporosis than men, but the exact reason isn’t clearly understood.
  • If your family has a history of early-onset low bone density or fractures (for example, if your parents have had low bone density), you may be at higher risk for developing it yourself.
  • People who smoke tend to have lower bone mass than those who don’t smoke. It’s not clear why this is true; some scientists think it might be because smoking affects how well our bodies absorb calcium from food sources like milk and cheese, but other research suggests that smoking increases inflammation within our bones, which can lead them to break down faster over time.

How are osteopenia and osteoporosis diagnosed?

Osteoporosis and osteopenia are diagnosed by DXA scan (bone density scan). The test measures your bone mineral density (BMD) or the amount of calcium in your bones. Low BMD could mean that you have osteopenia or osteoporosis, but it can also mean that you are not getting enough nutrients from food or supplements.

When you go to the doctor for this test, they will take several pictures using X-rays. It takes 15 minutes to complete the exam, and no pain is involved!

Measuring bone mineral density

A bone mineral density (BMD) test measures the amount of bone and its quality. BMD is also called a “bone scan.” Sometimes, you may need to get an additional test called a dual-energy x-ray absorptiometry (DEXA), which measures your BMD at multiple sites throughout your body. This test can tell how much of your skeleton is made up of calcium or other minerals that make up healthy bones and how much is made up of less dense spine deformities, tumors, or cysts.

The results will tell you if you have low bone mass — osteopenia — or osteoporosis.


Treatment for osteopenia and osteoporosis will depend on age and other health concerns. Your doctor might suggest any of the following:

  • Medications: Prescription drugs can help slow bone loss but don’t build new bone. These medications include bisphosphonates (like Fosamax), strontium ranelate (used in Europe), and estrogen supplements or hormone therapy (taken only by women).
  • Exercise: Weight-bearing exercises such as walking, jogging, or running are especially helpful for building bones because they stress your bones as you move. Strength training with weights also helps build muscle mass that maintains healthy bones by pulling against them while working out. Endurance exercises like cycling or swimming aren’t weight-bearing but improve overall strength. Combining both types of exercise is ideal for getting the benefits of both forms of exercise—and it may be easier than doing two separate workouts!
  • Diet: Getting enough calcium and vitamin D can help prevent further loss of bone density over time


What's worse, osteopenia or osteoporosis?

Osteoporosis and osteopenia can be prevented. It is important to follow a few key guidelines:

  • Stay active and maintain a healthy weight.
  • Limit alcohol consumption if you do drink, and avoid smoking.
  • Use medications as prescribed by your doctor.
  • Get enough sleep (about 8 hours per night), manage stress effectively, and don’t use tobacco products or consume more than one alcoholic beverage per day for women or two for men.

Contacting a doctor

What's worse, osteopenia or osteoporosis?

Once you’ve been diagnosed, it’s important to contact a doctor. You’ll want to find out what treatment options are available to you and if there are any additional steps you can take (like taking supplements or getting more exercise).

When you meet with your new doctor, it’s also important that you ask questions about how they plan on treating your disease and whether any alternatives may work better for your body type or lifestyle needs.


As we’ve seen, the main differences between osteopenia and osteoporosis are in the severity of their symptoms and in the way they’re treated. Osteopenia is a mild form of bone loss that can be managed with lifestyle changes and medications like calcium supplements or bisphosphonates. In contrast, osteoporosis is worse, requiring more aggressive treatment options such as hormone therapy or surgery. If you think you may have either disorder, it’s important to talk to the doctor about getting tested for it—especially if you fall into one of these high-risk groups.