If you've been told you have osteoporosis or low bone density, or you're wondering whether you're at risk, this page explains what it means, how it's diagnosed, and what actually helps. It is not medical advice — your GP knows your situation and will personalise any recommendations.
The most important thing to know: Osteoporosis usually causes no symptoms until a fracture happens — which is why it's sometimes called a "silent" condition. The good news: it's detectable with a simple scan, and there's a lot that genuinely reduces fracture risk — from calcium and vitamin D to specific exercise and, when appropriate, PBS-subsidised medication.
What osteoporosis means
Bone is living tissue that's constantly being broken down and rebuilt. Osteoporosis happens when bone breakdown outpaces rebuilding, leaving bones less dense and more fragile — increasing the risk of a fracture from a fall or bump that wouldn't normally break a bone (a "minimal trauma fracture"). Osteopenia (sometimes called "low bone mass") is an earlier, milder stage of bone density loss — not yet osteoporosis, but worth attention.
Both are measured using a bone density scan (DEXA), which compares your bone density to that of a healthy young adult and produces a T-score:
T-score
Category
−1.0 or above
Normal bone density
Between −1.0 and −2.5
Osteopenia (low bone mass)
−2.5 or below
Osteoporosis
−2.5 or below, plus a fragility fracture
Severe (established) osteoporosis
A minimal trauma fracture of the hip or spine in someone over 50 is generally treated as osteoporosis in its own right — even before a scan confirms the T-score.
How it's diagnosed
A DEXA (dual-energy X-ray absorptiometry) bone density scan is the standard test — quick, low-radiation, and usually of the hip and spine. Medicare covers a scan for specific groups (everyone 70 and over, anyone with a prior minimal trauma fracture, people on long-term steroids, and several other categories) — use the checker below to see which applies to you. Your GP may also use a fracture risk calculator (like FRAX) alongside or instead of a scan to estimate your 10-year risk and decide what's appropriate.
Per the RACGP/Healthy Bones Australia guideline, risk factors include:
Age — risk roughly doubles each decade after 50
Sex — women are affected more often, especially after menopause (falling oestrogen accelerates bone loss)
Previous minimal trauma fracture, or a parent (especially mother) with a hip fracture
Early or premature menopause (before 45), or low testosterone in men
Falls — more than one fall in the past 12 months
Low body weight (BMI under 20) or unintentional weight loss
Smoking and alcohol intake over 10 standard drinks/week
Low calcium intake or vitamin D deficiency
Inactivity, poor balance, or low muscle mass
Certain conditions — rheumatoid arthritis, coeliac disease, hyperthyroidism, chronic kidney or liver disease, diabetes
Certain medications — particularly long-term oral steroids (prednisone-type, 3+ months), and to a lesser extent some antidepressants, antipsychotics, and reflux medications (PPIs)
What helps
Several things are genuinely evidence-based for bone health — not just "good in general":
Calcium — from food first
NHMRC targets: 1000mg/day for most adults, rising to 1300mg/day for women over 50 and men over 70. Aim to get this from dairy, calcium-fortified alternatives, canned fish with bones, and leafy greens before reaching for a supplement — supplements are for closing a genuine dietary gap, not a routine top-up. Use the calcium intake calculator to see where you're at.
Vitamin D — from safe sun exposure or a supplement
Vitamin D helps your body absorb calcium. The target is a blood level above 50 nmol/L; supplementation (typically 800–1000 IU/day) is recommended if you're deficient. See the vitamin D calculator for requirements by age and skin type.
Weight-bearing and resistance exercise
Bone responds to load. Healthy Bones Australia recommends resistance/strength training at least twice a week plus weight-bearing impact activity most days — brisk walking, stair climbing, dancing, jogging if appropriate for you — along with balance training to reduce fall risk. If you already have osteoporosis or a prior fracture, a supervised program with a physiotherapist or exercise physiologist is safest, since some exercises (heavy spinal flexion or twisting) are best avoided.
Reduce falls risk at home
Most fractures happen after a fall, not spontaneously. Good lighting, removing loose rugs/trip hazards, hand rails where needed, appropriate footwear, and having your vision checked all measurably reduce falls.
For confirmed osteoporosis or a significant fracture risk, several PBS-subsidised medications are available: oral bisphosphonates (alendronate, risedronate), IV zoledronic acid, 6-monthly injectable denosumab, and for higher-risk cases, bone-building agents like romosozumab or teriparatide. Which one (if any) suits you depends on your fracture risk, kidney function, dental health, and preferences — this is a conversation with your GP, not a general recommendation. If cost is a factor, the PBS price checker and MedCost Finder can help you plan.
When to see your GP
You've broken a bone from a fall or bump that seems minor for the injury
You have several risk factors above and haven't had a bone density discussion
You've been on long-term steroid tablets
You're a woman going through early menopause, or a man with symptoms of low testosterone
You've lost height, or have new back pain without an obvious cause (can be a sign of a vertebral fracture)
You're already on osteoporosis medication and have questions about side effects, how long to continue, or whether a "drug holiday" applies to you
When it's urgent
You can't bear weight, or you have obvious deformity, after a fall (possible hip or limb fracture) — call 000 or go to your nearest ED
Sudden, severe back pain after even minor strain, lifting, or a fall — a possible spinal (vertebral) fracture
Any fall with head injury, loss of consciousness, or if you're on blood thinners
Common questions
No — osteoporosis itself is painless. Pain usually only appears once a fracture has occurred (for example, sudden back pain from a vertebral fracture). That's exactly why it's picked up by screening and risk assessment rather than symptoms.
It's most common in postmenopausal women, but men get it too — particularly with risk factors like low testosterone, steroid use, or heavy alcohol intake. According to the International Osteoporosis Foundation, worldwide around 1 in 3 women and 1 in 5 men over 50 will have an osteoporotic fracture in their lifetime.
Bone density can improve with treatment and lifestyle change, though the main goal of treatment is to reduce fracture risk rather than fully "cure" the condition. Anti-resorptive medications slow bone loss; bone-building medications can meaningfully increase density in higher-risk patients. Improvement is measurable but gradual — repeat scans are usually spaced 1–2 years apart.
Yes, if you're in a group where screening is recommended — since osteoporosis is silent, waiting for symptoms means waiting for a fracture. Everyone 70 and over is eligible for a Medicare-rebated scan regardless of symptoms; younger people with specific risk factors also qualify. Use the eligibility checker above to see where you stand.
There are several alternatives if oral bisphosphonates cause reflux or aren't suitable — an IV infusion (zoledronic acid, once every 12–18 months), an injection (denosumab, every 6 months), or for higher-risk cases, bone-building agents. Talk to your GP about which fits your situation, kidney function, and preferences.
👩⚕️ For clinicians: see the falls risk screening tool — relevant since most osteoporotic fractures follow a fall.
Support and resources Healthy Bones Australia — healthybonesaustralia.org.au — patient fact sheets, exercise guides, support Healthy Bones Australia support line — 1800 242 141 Quitline (if you smoke) — 13 7848