Osteoporosis: The Silent Disease We Often Diagnose Too Late

By: Mehdia Amini, MD

Every three seconds, someone worldwide suffers an osteoporosis-related fracture. One in three women and one in five men over the age of 50 will experience an osteoporotic fracture during their remaining lifetime.

Yet osteoporosis remains one of the most underdiagnosed and undertreated chronic diseases.

What makes osteoporosis particularly concerning is that bone loss is asymptomatic. It does not cause pain or other noticeable symptoms. Patients can lose substantial bone density over decades without realizing anything is wrong.

As an endocrinologist, I frequently see patients when the consequences have already become apparent: a compression fracture of the spine, a broken hip, significant height loss, or the characteristic forward curvature of the upper back, known as kyphosis.

By that point, substantial skeletal damage may already have occurred.

Bone Loss Begins Earlier Than Most People Realize

Peak bone mass is generally achieved by the late twenties to early thirties. Thereafter, bone density may begin to decline gradually, with the rate of loss accelerating significantly in women during the menopausal transition due to declining estrogen levels.

Despite this, routine osteoporosis screening for women at average risk generally begins at age 65.

For some women, waiting until 65 is already too late.

Individuals with additional risk factors may require earlier evaluation. Maintaining bone health through adequate nutrition, resistance and weight-bearing exercise, and recognition of conditions that accelerate bone loss should begin much earlier in adulthood.

Osteoporosis Is Not Just a Women’s Disease

Although osteoporosis is more common in postmenopausal women, men are also affected, and the condition is frequently overlooked in this population.

Approximately one in five men over age 50 will experience an osteoporotic fracture during his remaining lifetime. Medical conditions such as testosterone deficiency, thyroid hormone excess, and prolonged glucocorticoid exposure can contribute to bone loss in men.

Importantly, men who sustain hip fractures have higher subsequent mortality rates than women.

Osteoporosis deserves the same clinical attention in men as it does in women.

A Hip Fracture Can Change the Course of a Person’s Life

For many older adults, maintaining independence is central to their quality of life. The ability to walk, care for themselves, and continue living in their own homes is something they may have spent decades taking for granted.

A single hip fracture can change all of that.

What begins as a seemingly minor fall can result in major surgery, prolonged hospitalization, loss of mobility, and permanent disability. Some patients become bedridden during recovery, while others never regain their ability to walk independently.

The statistics are sobering. Following a hip fracture, approximately 40% of patients are unable to walk independently, 60% require assistance one year later, and nearly one-third become completely dependent or require nursing home care. Even more concerning, an estimated 20–24% die within the first year.

For an older adult, a hip fracture can mark the devastating transition from living independently to being unable to walk, dress, or care for themselves without assistance. For some, that independence is never regained.

Preventing osteoporotic fractures is therefore not simply about preserving bone density. It is about preserving mobility, independence, and quality of life.

Prevention Should Begin Before the First Fracture

Osteoporosis is not simply an inevitable consequence of aging.

Although genetics and hormonal changes influence bone health, regular resistance training, weight-bearing exercise, adequate calcium, vitamin D and protein intake, and early identification of medical conditions that accelerate bone loss can help preserve skeletal strength.

For individuals already diagnosed with osteoporosis, effective treatments are available that significantly reduce the risk of future fractures.

Take Action Before the First Fracture

Osteoporosis develops silently, often over decades. By the time a fracture occurs, significant bone loss may already be present.

Don’t wait until a fracture threatens your mobility, independence, or quality of life.

Whether you are concerned about your bone health, have risk factors for osteoporosis, or have already experienced a fracture, an endocrinology evaluation can help you understand your individual risk and explore appropriate treatment options.

Schedule a consultation with Dr. Mehdia Amini, endocrinologist, for a comprehensive bone health evaluation and an individualized plan to protect your skeletal health and reduce your risk of future fractures.