Osteopenia
Bone density lower than normal but not low enough to be classified as osteoporosis (T-score between -1.0 and -2.5). Osteopenia indicates increased fracture risk and may progress to osteoporosis. Lifestyle interventions and monitoring are typical management; pharmacotherapy may be considered for high-risk individuals.
Technical Context
T-score between -1.0 and -2.5 at any measured site. Prevalence: approximately 50% of postmenopausal women. Not all osteopenia progresses to osteoporosis — rate depends on age, BMD trajectory, and risk factors. Management: lifestyle interventions (weight-bearing exercise, adequate calcium 1000-1200mg/day, vitamin D 800-1000 IU/day, fall prevention, smoking cessation), FRAX assessment to quantify fracture risk, and pharmacotherapy only if FRAX probability exceeds treatment thresholds (US: ≥3% hip fracture or ≥20% major osteoporotic fracture). Monitoring: repeat DEXA in 1-2 years if near osteoporosis threshold, otherwise every 3-5 years. Osteopenia represents the at-risk population where prevention may avoid the need for osteoporosis pharmacotherapy.