Summary

• Asymptomatic until fracture occurs.
• Diagnosis based on history of prior fragility fracture or low bone-mass density, which is defined as a T-score <-2.5.
• Screening is based on individual risk factors, including female gender, maternal history of fragility fracture/osteoporosis, older age, low body mass index (<20 to 25 kg/m^2), body weight <58 kg, weight loss of >10% of body weight, androgen deprivation treatment (in males), aromatase inhibitor treatment (in females), corticosteroid use, tobacco use, and kidney stone disease.
• Fall prevention is first-line therapy.
• Bisphosphonates are first-line pharmacological therapy for postmenopausal women and men.
• In postmenopausal women, oestrogen is considered only for those at high risk for whom non-oestrogen medicines are inappropriate.