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Osteoporosis Risk Assessment

The following questionnaire gives a sense of the likelihood of having or developing osteoporosis.

Are you over the age of 50?
Yes
No
Are you postmenopausal? Yes No
Did you experience early onset of menopause (before the age of 45)? Yes No
Do you have a light-skinned complexion? Yes No
Are you naturally thin-boned in body build? Yes No
Are you Caucasian or of Asian descent? Yes No
Do you lead a inactive lifestyle, with little daily exercise? Yes No

Do you have an immediate family member (parent, sibling, or child) who has had osteoporosis?

Yes No
Do you limit the amount of sun you receive in the course of a year? Yes No
Have you never or only sporadically taken supplements that include vitamin D and calcium? Yes No

Do you have a diet with little calcium intake?

Yes No
Have you experienced past bone fractures? Yes No
Have you experienced collapsed vertebra, stooped posture, or loss of height? Yes No
Do you smoke? Yes No

Do you drink the equivalent of more than two alcoholic drinks per day?

Yes No

Is your nutrition and health generally poor?

Yes No

Do you drink caffeine-containing drinks regularly or in significant amounts (more than two daily)?

Yes No
Have you ever been diagnosed with an eating disorder? Yes No

Have you had extended periods in your life without a menstrual cycle?

Yes No
Have you ever or recently taken steroids, thyroid hormones, or any other medications that can negatively affect bone strength, for an extended period of time? Yes No
Do you have either rheumatoid arthritis, hepatitis C, or hyperthyroidism? Yes No


The more often you answered “Yes” to the above questions, the greater your risk for developing or already having a sexually transmitted disease.  If you answered “Yes” to questions above, consider discussing osteoporosis with one of our Women’s Center healthcare providers.

Print this page and bring it with you, filled out, to your appointment.

 

>> See also the Osteoporosis Risk Assessment for Women in Aria's Health Information Library.