Why Are Women More Likely to Get Osteoporosis?

Osteoporosis is a progressive bone disease that develops when bone mass or mineral declines, destabilizing the compact structure that makes osseous tissue (bone) hard, tough, dense, and durable. These degenerative changes cause a significant decrease in bone strength, substantially increasing the risk of a fracture or bone break.

Of the 10 million adults in the United States who’ve been diagnosed with osteoporosis, eight million (80%) are women. This means women account for four in five osteoporosis cases.

So, why are women four times more likely than men to get osteoporosis? Here, our Capital Women’s Care team discusses why women — especially after menopause — are so vulnerable to this “silent disease” and explains how to protect your bone health as you age.

Osteoporosis causes accelerated bone loss.

Like all bodily tissues, bones are in a continual state of growth, resorption, and renewal. After reaching peak mass (around 30), the bone resorption rate slowly begins to outpace its regrowth, causing a gradual—but not critical—decline in mass.

Osteoporosis occurs when some influencing factor pushes bone mass decline beyond its usual bounds, causing detrimental changes in bone tissue structure. That factor could be:

Older age (past the age of 50)
Genetic disposition (family history)
Having a smaller skeletal frame
Not getting enough physical activity
Calcium or vitamin D deficiencies
Smoking cigarettes (tobacco use)
Excessive alcohol consumption
Effects of certain chronic illnesses
Side effects of certain medicines

Although younger adults can experience accelerated bone loss, older age is the primary risk factor for osteoporosis. The other major risk factor is female gender.

Women are at increased risk of osteoporosis

Female gender is a major osteoporosis risk factor for three reasons:

Women typically have thinner, smaller bones
Women tend to have lower peak bone mass
Women go through menopause in middle age

Osteoporosis is most common among older women because of the estrogen loss that occurs with menopause. Why? This important female sex hormone doesn’t just regulate menstruation and fertility — it also plays an active role in continued bone health.

When estrogen starts dwindling during middle age, osteoporosis often begins to take root. Postmenopausal bone loss is often rapid, too — a woman can lose up to 20% of her bone density in the first five years after menopause.