Most Fragility Fractures Don’t Happen in Osteoporosis

Added: 2026-05-25

[00:00:00]The reason why osteopenia is listed as a risk factor and potentially an indication for pharmacologic therapy is because most fractures, fragility fractures, occur in women without osteoporosis. And that might blow your mind, but remember what I said earlier, bone density is actually not the best indicator of risk of fracture. It's actually a previous fracture. So, you can have better bone density than a diagnosis of osteoporosis would show, but still have other risk factors like a previous fracture, genetic history, parathyroid, like all these things can happen and your bone density is actually not that bad yet. So, you could have osteopenia and then use some risk factors and FRAX and have some numbers specifically on FRAX that would then also drive you down a clinical guideline that would have your doctor recommend drug therapy for you.