Osteopenia, known as "low bone mass" or "low bone density", is a condition in which bone mineral density is low. Because their bones are weaker, people with osteopenia may have a higher risk of fractures, and some people may go on to develop osteoporosis. In 2010, 43 million older adults in the US had osteopenia. Unlike osteoporosis, osteopenia does not usually cause symptoms, and losing bone density in itself does not cause pain. There is no single cause for osteopenia, although there are several risk factors, including modifiable (behavioral, including dietary and use of certain drugs) and non-modifiable (for instance, loss of bone mass with age). For people with risk factors, screening via a DXA scanner may help to detect the development and progression of low bone density. Prevention of low bone density may begin early in life and includes a healthy diet and weight-bearing exercise, as well as avoidance of tobacco and alcohol. The treatment of osteopenia is controversial: non-pharmaceutical treatment involves preserving existing bone mass via healthy behaviors (dietary modification, weight-bearing exercise, avoidance or cessation of smoking or heavy alcohol use). Pharmaceutical treatment for osteopenia, including bisphosphonates and other medications, may be considered in certain cases but is not without risks. Overall, treatment decisions should be guided by considering each patient's constellation of risk factors for fractures. Many divide risk factors for osteopenia into fixed (non-changeable) and modifiable factors. Osteopenia can also be secondary to other diseases. An incomplete list of risk factors: Age: bone density peaks at age 35, and then decreases. Bone density loss occurs in both men and women Ethnicity: European and Asian people have increased risk Sex: women are at higher risk, particularly those with early menopause Family history: low bone mass in the family increases risk Tobacco use Alcohol use Inactivity – particularly lack of weight-bearing or resistance activities Insufficient caloric intake – osteopenia can be connected to female athlete triad syndrome, which occurs in female athletes as a combination of energy deficiency, menstrual irregularities, and low bone mineral density.

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An estrogen (E) is a type of medication which is used most commonly in hormonal birth control and menopausal hormone therapy, and as part of feminizing hormone therapy for transgender women. They can also be used in the treatment of hormone-sensitive cancers like breast cancer and prostate cancer and for various other indications. Estrogens are used alone or in combination with progestogens. They are available in a wide variety of formulations and for use by many different routes of administration.
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