A recent guideline by the US Preventive Services Task Force recommends that women have Bone Mineral Density Testing (BMD) starting at age 65 or as early as 60 only if there are risk factors.
Most clinicians I know ask their patients to have a Bone Mineral Density (BMD) Test around the time that their periods stop during the menopausal transition because virtually every woman has at least 1 risk factor. This first BMD provides the woman and her health care provide a baseline understanding of where she is. Once we get the first snapshot of her bone health, then we can make an individualized plan for when to check again.
Why not wait until 65 or 60?
The reason I start Bone Mineral Density testing earlier than what’s recommended is that by the time a woman reaches 60 or 65, most of her bone loss has already occurred and we’re too late for prevention.
• We know that the drop in estrogen levels during the menopausal transition lead to a rapid loss of bone mass.
• If you wait to test at 65 or even 60, most of the bone loss will have occurred already.
• An increased loss of bone leads to an increased risk of breaking or fracturing a bone.
Seeing is Believing
Most of us need some motivation for changing our behaviors. Seeing results on paper that clearly show where the bone is weaker is one of the best ways to help educate and influence women to get their recommended amounts of weight bearing exercise, calcium and Vitamin D. There’s nothing better to motivate healthier choices than seeing the evidence of your own risk of fracturing a bone in the spine or hip.
What Osteoporosis looks like:
Normal bone, while not solid as you might expect, is much more dense than osteoporotic bone that has more space in between the supporting and thinning bone’s structures. You can see how thin the supporting structures are and also how easy it would be to break bone that is this thin.
Why it happens:
After menopause, as estrogen levels decline the normal bone remodeling that is always occurring, changes. More bone is broken down and less is built up. There’s a net loss of bone over time, leading to less density and more likelihood of fracture.
Many women and men who take thyroid medication, steroids or other medications and those with a family history of osteoporosis, those who have not had much calcium throughout their lives, and women who are underweight are also at increased risk of losing bone mass.
- Prevention is key. Making sure to have plenty of bone’s building blocks of calcium and vitamin D throughout life will help ensure that the bone is as dense as possible prior to menopause and beyond.
- Weight bearing exercise helps strengthen bone and actually makes the bone work harder to stay dense.
- Our bones like it when we walk, dance, stand or run.
- Once you have the results of the BMD, use the FRAX calculator that takes all the risk factors for fracture in to account including age, race, height, weight and other lifestyle factors such as smoking that increase the risk of breaking a bone.
- There are many prescription medications available to help. Some can be taken orally, others are given by injection.
What you can do
Do speak to your own health care provider about the best time to have your bone mineral density tested.
For more tips, please check out my new book, The Hot Guide to a Cool Sexy Menopause. It’s available on Amazon, Barnes and Noble, for E-readers, wherever books are sold and through Basic Health Publishing.