Screening for Osteoporosis (thin bones)?

After the age of 25-30, most of us reach our peak bone mass.  Then we slowly start to lose bone mass.  How fast or slow that happens depends on many factors: genetics, gender, diet, exercise and other factors.  After menopause, with the decline in estrogen, women start to lose bone mass at a faster rate.  

Thinning bones are a normal part of aging.  The issue is when they’re thin enough to fracture from low-impact trauma.   That’s what we call Osteoporosis.

The USPSTF recently published updated guidelines for who needs to be screened for osteoporosis:

  • All women aged 65 and older
  • All postmenopausal women under the age of 65 with increased risk (as determined by a calculator)

Remember these are screening guidelines for otherwise healthy adults who have no history of fractures, increased risk of falls, or other medical conditions that put them at higher risk for thinner bones.   Women (and men) with these issues would fall under different recommended guidelines.’

Conditions that increase your risk of osteoporosis:

  • Previous fracture
  • Tobacco abuse
  • Alcohol consumption
  • Rheumatoid arthritis
  • Insulin dependent diabetes
  • Untreated hypothyroidism
  • Chronic use of steroids
  • Hypogonadism
  • Menopause at or before 45
  • A hip fracture in a parent

What’s the screening like?

The most common test to screen for osteoporosis is called a DXA scan (dual-energy x-ray absorptiometry).  These are similar to x-rays of the spine and hip.

What’s the point?

There is very good data that in the appropriate group (women over 65 or postmenopausal women with other risk factors), DXA scans are good and identifying women with osteoporosis AND that treating these women is helpful at preventing fractures.

If you’re a woman over the age of 65, you should have (or have had) a DXA scan recently.   If not, bring it up with your OB/GYN at your next visit.   If you’re postmenopausal, under the age of 65 and worried you have risk factors for osteoporosis, you can use a calculator to see if your risk is high enough to warrant an earlier DXA scan.   It’s always best to raise these issues with your OBGYN.







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