This condition of thinning bones (bones with increasing spaces like Swiss cheese) which leads to fragile bones and fractures, especially of the hips and spine. Women of post-menopausal age are most often affected due to reductions in their estrogen levels. Such women can be treated with a bone specific estrogen to prevent this disease. Bone (DEXA) scans can be used to identify osteoporosis or osteopenia of the hips and lower (lumbar) spine. Women with a family history of fractures of the hip or spine should be screened after their menopause. If present, bony repair can be induced by a class of drugs named biphosphonates. Adequate vitamin D and calcium are usually available in sufficient quantities from sun-light exposure and a balanced diet and patients do not benefit from their administartion. The Clinic rarely advises such supplements since they are ineffective and an over-dose can be harmful. Men can develop osteoporosis too, as can children who are unable to move around normally due to paralysis.