Bone Density Screening
By Alexis Halling PA-C
When should I have a bone density scan?
Bone Density Screening – For premenopausal women, a bone density scan is rarely necessary unless there is a relevant chronic disease known to affect bone density. However, the reproductive years (teens-40s) are an important time to build and maintain bone strength to protect again osteoporosis and life-altering hip and spine fractures in the future.
Once in menopause, if a woman is noticing height loss (a sign of potential vertebral fracture), breaks a bone, or develops new back/spine pain, a bone density scan may be recommended. In addition, a bone density scan may be recommended in menopausal women with risk factors for bone loss such as smoking, drinking more than 2 alcoholic drinks daily, using glucocorticoid medications long-term, having rheumatoid arthritis, having a low weight, or if your mother ever broke her hip. For those at high-risk, check with your provider at your annual visit about when it is recommended to have a bone density scan.
Regardless, is recommended that post-menopausal women have a bone density scan by age 65. Osteoporosis does not typically cause pain or other symptoms until there is a broken bone. Spine and hip fractures can be serious. Checking for whether you are at risk before there is an incident is why screening is recommended.
How does a bone density scan work?
A test called dual-energy X-ray absorptiometry, or a DEXA scan, is used to determine bone density. It utilizes low levels of X-rays and takes only a few minutes. The most useful result for post-menopausal people is the “T-score,” which is in terms of standard deviations from the mean bone density of a healthy 30-year-old person (age of peak bone mass). A T-score below -2.5 is consistent with a diagnosis of osteoporosis. Osteoporosis can also be diagnosed if a person experiences a “fragility fracture” or breaks a bone by a low-impact mechanism such as falling from standing.
How can I prevent osteoporosis?
Of course, everyone hopes that their DEXA scan result shows strong healthy bones. A lot of whether a person has osteoporosis or not is simply her age plus her genetics. Various hormones play critical roles in signaling the buildup and breakdown of bone. There is a constant turnover happening in normal healthy bones. Once a woman is past menopause, the low levels of circulating estrogen lead to a gradual net loss of bone. However, as mentioned before, the lifelong habits of a person contribute to the baseline density of bone when she enters the menopause transition. Regular calcium intake, ideally through the foods eaten, or through a supplement, vitamin D supplementation, and consistent weight-bearing exercise such as walking or running, and strength training are centrally important to maintaining bone density and decreasing the rate of decline.
The annual preventive visit with a women’s health provider is when this screening is discussed. For women before menopause, these annual visits are also when discussions are had regarding calcium intake and appropriate types of physical activity to help build and maintain strong bones throughout your life. If you have any questions or concerns, please bring these to your annual physical exam, we would love to see you!