Hear the term osteoporosis, and most people instantly imagine a slightly stooped older woman.

But according to Jennifer Kelly, DO, endocrinologist and director of University of Vermont Medical Center’s metabolic bone program, that’s far from a complete picture of this common condition. So we asked her a few questions to “bone up” on the subject.

Why Is Osteoporosis Dangerous?

Osteoporosis occurs when our bones lose density and strength, which typically happens as we age. A lack of calcium and Vitamin D in the diet, particularly during childhood, adolescence and young adulthood, can put people at higher risk later in life.

Osteoporosis has no symptoms, so people often only realize they have it when they break a bone. Unfortunately, that break can have far-ranging consequences, especially if the break occurs in the hip.

“People who break a hip, especially after age 70, have a hard time regaining their mobility. Twenty percent of people who fracture a hip pass away within a year,” says Dr. Kelly, noting that a more sedentary lifestyle often leads to, or exacerbates, other health problems.

Who Is Most at Risk?

Women are at highest risk, specifically non-Hispanic white women and Asian women. But people of all genders, races and ethnic groups are at risk of developing osteoporosis as they age.

“One out of every two women over age 50 will have an osteoporotic fracture in their lifetime,” Dr. Kelly says, “and one out of every five men in the same age group. So while the risk is lower for men than for women, it’s still significant.”

“Also, men tend to do worse after a fracture than women do,” she says. “Their mortality rate is higher than it is for women.”

Are Bone Issues Only a Concern for Older Adults?

It’s rare for bone loss to happen at a young age, unless the person has a history of an underlying medical condition or takes medications that put them at risk.

But, Dr. Kelly says, prevention is really important for young people.

“We achieve peak bone mass around our mid-20s. So young people really need to pay attention to prevention,” she says. “They can do that by taking in adequate amounts of calcium and vitamin D and performing regular weight-bearing exercise.”

What Are the Recommended Amounts of Calcium and Vitamin D?

Between diet and supplements, we should aim for 1200 mg of calcium daily. Yogurt, cheese and green vegetables are all good sources of calcium, as are soy and almond milk and some varieties of orange juice.

But don’t overdo it, Dr. Kelly cautions. A daily calcium intake above 2000 mg puts you at risk for calcifications and kidney stones.

“Vitamin D is harder to get from diet alone, so supplements are typically needed,” Dr. Kelly says. “People should aim for 1000 to 2000 units per day.”

What About Physical Activity?

People of all ages should strive for 30 minutes of weight-bearing exercise, five days a week. The 30 minutes don’t have to happen all at once, and “weight-bearing” doesn’t necessarily mean lifting weights. “Anything that puts impact on bone, such as walking or jogging, is great,” says Dr. Kelly. However, people should be cautious with their activities if they have any physical limitations. It’s always best to check with your doctor before beginning an exercise program.

People over 50 should also think about fall prevention. “Be careful outside in the winter with ice,” she says. “And inside, you should minimize things like throw rugs and exposed cords, which could become tripping hazards.”

Which Screening Is Recommended?

Because there are no symptoms for osteoporosis until you break something, often the only way you know you’re at risk is through screening.

Dr. Kelly says that the standard test for bone density is a dual x-ray absorptiometry, or DXA, pronounced “Dexa.” Women should go for their first screening at age 65, and men should start at age 70. Screening can start sooner, at age 50, if a person has risk factors for bone loss.

“Again, people don’t tend to think of men being at risk for osteoporosis. So most men don’t get screened, and the first time I meet them is when they’ve had a fracture,” Dr. Kelly says. “Men should absolutely be tested.”

Are There Medications to Slow Osteoporosis? 

"Yes," says Dr. Kelly.

The most commonly prescribed bone-strengthening medications are bisphosphonates. Patients may be familiar with the brand names Fosamax or Boniva. There are also different injectable medications available for people who are at very high risk for fracture.

“Sometimes I have patients who are concerned about very rare side effects because they’ve read something online about potential complications, and they choose not to take a medication to prevent fracture,” says Dr. Kelly. “I try to reassure people that the medications that we have available are very safe and effective. When the chance of having an osteoporotic fracture is either 1 in 5 or 1 in 2, you just can’t compare the numbers to a rare side effect that can occur in 1 in 10,000 people.”