Important: This page provides general information only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your bone health, please speak to your GP.
Osteoporosis Risk Factors
Several factors influence your risk of developing osteoporosis and sustaining a fragility fracture. Some of these you cannot change (non-modifiable), but many others you can actively address. Understanding your risk is the first step.
Important: Having risk factors does not mean you will definitely develop osteoporosis — it means your risk is higher than average. A DXA scan is the only way to know your actual bone density. Talk to your GP if you are concerned.
Non-Modifiable Risk Factors
These are factors you cannot change, but knowing about them helps you and your GP assess your overall risk.
Age
Bone density naturally declines with age. Risk increases significantly after 60.
Female sex
Women have lower peak bone mass than men and lose bone rapidly after menopause.
Early menopause
Menopause before age 45, whether natural or surgical, significantly increases risk due to earlier oestrogen loss.
Family history
A parent (especially a mother) with osteoporosis or a history of hip fracture increases your risk.
Body frame
Small body frame (low body weight) means less bone mass to begin with.
Ethnicity
People of Caucasian or Asian ethnicity have higher risk, though osteoporosis affects all ethnicities.
Modifiable Risk Factors
These are factors within your control — addressing them can meaningfully reduce your risk of osteoporosis and fractures, even if you already have some non-modifiable risk factors.
Low calcium diet
Calcium is the primary mineral in bone. Consistently low intake reduces bone density over time.
Vitamin D deficiency
Essential for calcium absorption. Very common in Ireland due to limited sunlight, particularly October to March.
Physical inactivity
Weight-bearing and resistance exercise stimulate bone formation. A sedentary lifestyle accelerates bone loss.
Smoking
Smoking directly harms bone-forming cells and reduces oestrogen levels. It doubles the risk of fracture.
Excess alcohol
More than 14 units per week interferes with bone formation and increases fall risk.
Low body weight
BMI below 18.5 is a significant independent risk factor for osteoporosis.
Long-term corticosteroid use
Medicines like prednisolone, taken for 3+ months, significantly reduce bone density. Never stop without GP advice.
Medical Conditions That Increase Risk
A number of underlying health conditions are associated with lower bone density. If you have any of the following, make sure your GP is aware and discuss whether bone density monitoring is appropriate for you:
- Coeliac disease (untreated)
- Inflammatory bowel disease (Crohn's, ulcerative colitis)
- Rheumatoid arthritis
- Hyperthyroidism (overactive thyroid)
- Hypogonadism (low sex hormone levels in men)
- Type 1 diabetes
- Chronic kidney disease
- Primary hyperparathyroidism
- Anorexia nervosa
- Premature ovarian insufficiency
Certain medications beyond corticosteroids can also affect bone density — including some anti-epileptic drugs, aromatase inhibitors (used in breast cancer treatment), and proton pump inhibitors (PPIs) when used long-term. If you take any of these, do not stop without speaking to your GP, but do ask about bone health monitoring.
The FRAX Tool
The FRAX fracture risk assessment tool (developed by the University of Sheffield for the WHO) combines several of these risk factors to calculate your 10-year probability of a hip fracture or major osteoporotic fracture. Your GP may use it alongside a DXA scan to guide decisions about treatment.
You can learn more on our FRAX Fracture Risk Tool page.
Talk to Your GP
If you recognise several risk factors that apply to you, speak to your GP. They can assess your risk and arrange a bone density (DXA) scan if appropriate.
You can say: “I'd like to discuss my bone health and whether I should have a DXA scan.”
Questions to Ask Your DoctorLast reviewed: February 2026 — FragilityFracture.ie Editorial Team