Osteoporosis Screening: Who, How, When, and Why

Question: I'm in my mid-70s, and I've always been a fairly active, healthy lady. My neighbor, who's about my age, has me worried, though. She was recently told that she had broken a bone in her back because of osteoporosis. Now my neighbor says that I should get tested for osteoporosis, too. In fact, she says all women should be tested. My doctor has never mentioned a test, so I assume my bones are healthy enough. Do you think I should get tested? I have a 51-year-old daughter. Should she be worried about osteoporosis, too?
—Lake Forest, IL
Osteoporosis word cloud concept with abstract backgroundAnswer: Your neighbor is right on this one: as a woman over 65, you should be screened for osteoporosis. It's a condition that weakens your bones by changing how quickly and effectively you regenerate bone. It's often painless. You may not have any idea that you're losing bone faster than you're replacing it.

But if you're not in pain, why does it matter if you're losing bone mass?
Your neighbor provides a good answer to this. It sounds like she didn't know she had osteoporosis until the doctor found a fracture in her vertebra. That fracture means her bones are so weakened that they aren't physically able to support her weight and so a vertebra broke. She might not be in pain now, but without treatment, osteoporosis could lead to more spinal fractures, a lot of pain, a loss of height, and a hunched back.

Fractures are the biggest danger associated with osteoporosis. The National Osteoporosis Foundation says that about 20% of seniors who break a hip die within a year because of complications from the fracture or from surgery to fix it. Spinal fractures are also linked to increased risk of death.

Even if you don't have a fracture, osteoporosis can drastically change your life because you have to be very careful to prevent a fracture. Weak bones can keep you from living life as you want. They can make it harder to move, and they can prevent you from doing activities you enjoy—and that includes "easy" activities like gardening. You may be scared to lift anything too heavy or even to pick up your grandchild because you're nervous about breaking a bone.

And that's why you should be tested for osteoporosis.
If your bones aren't weak right now, you want to keep them that way.

If your bones are weak, you want to do whatever you can to strengthen them to avoid a fracture. The only way to know how healthy your bones are is to have a bone mineral density (BMD) test done. It's a quick test that shouldn't take more than 10 minutes, and it's the most accurate way to assess the strength of your bones and your risk of fractures.

To learn more about getting your bone density tested, I recommend this article on how the BMD test is done.

Your BMD test results will help your doctor develop an osteoporosis prevention or treatment plan. For example, if your test shows that your bones are somewhat weak but not so weak that it could be called osteoporosis, he or she may recommend that you increase your calcium and vitamin D intake, both key ingredients to building bones. The doctor may also recommend getting more exercise because that helps strengthen bones.

If the BMD test reveals very low bone mineral density (osteoporosis), your doctor will work with you to decrease bone loss and prevent fractures. That could mean taking a prescription medication shown to increase bone density. You'd take that in conjunction with watching your diet and exercising.

Who should be tested for osteoporosis?
As a woman over 65, you should definitely be tested. After menopause and as you grow older, you're more likely to have weakening bones, so you need to keep track of your bone health.

Your 51-year-old daughter could also be tested, especially if she's already gone through menopause. Right after menopause, women begin losing bone density at a faster rate because their body stops producing estrogen, a hormone that (among other things) protects our bones. If your daughter is screened now, she has a better chance of slowing down the bone loss process and preventing osteoporosis.

Men need to be tested, too, for osteoporosis. It may be more common among women, but that doesn't mean they can't get it. Here's a list of who should be tested:

  • A person of any age who has an x-ray that reveals low bone mass, which could mean osteopenia or possibly osteoporosis
  • Women who start menopause early (before 45) and who are not taking estrogen (e.g., Estrogen Replacement Therapy, ERT)
  • A woman age 65 or older
  • A woman who's gone through menopause who has one or more of the osteoporosis risk factors and especially if she's had a fracture
  • A man age 70 or older
  • A man age 70 or younger who has one or more of the osteoporosis risk factors
  • Someone who takes (or has taken) corticosteroids regularly
  • Someone who has hyperthyroidism, diabetes, liver/kidney disease, rheumatoid arthritis

For the health of your bones and especially your spine, please take your neighbor's suggestion and get screened for osteoporosis.