Health-conscious women who wouldn't dream of skipping their Pap test or
mammogram appointments can be woefully ignorant about another type of vital
health check -- the bone density test.
This quick and painless evaluation, often done for the first time after menopause, can help predict whether you'll sprint
through your middle years and beyond, or shuffle along painfully due to
thinning bones and fractures. More importantly, the test results can help your
doctor decide if medication or lifestyle changes are needed now to rescue your
For years, we've thought we understood osteoporosis: it's a disease in
which the bones become more and more fragile as they lose density, usually due
to aging, menopause, and other factors like lack of calcium and
vitamin D in the diet.
But today, advances in research are shedding new light on osteoporosis,
which is predicted to affect as many as half of all Americans over age 50 by
the year 2020. From diagnosis to prevention to osteoporosis treatment, new research is turning our old
"Bone density tests turn out to be a good predictor of fracture
risk," says Felicia Cosman, MD, clinical director of the National
Osteoporosis Foundation in Washington, and a New York physician. Minimizing
that risk is important, because the older you are, the more serious a fracture
can be -- often resulting in lengthy hospitalization and long-term loss of your
And certain women are at higher risk of low bone mass, called osteoporosis,
in which bones are likely to fracture. What increases your osteoporosis
Taking certain medications, such as corticosteroids
Lifestyle factors: Alcohol use; getting little exercise; smoking; drinking
cola; a diet low in calcium, phosphorus, and vitamin D.
Unfortunately, many women are unsure if -- and when -- they need a bone
density test, if they're aware of the test at all.
When Should You Get That First Bone Density Scan?
Some of the confusion about the test is understandable because official
recommendations and advice from physicians on when to first get tested isn't in
For instance, the National Osteoporosis Foundation as well as the American
Association of Clinical Endocrinologists recommends all women aged 65 and over
, as well as women and men after age fifty who experience fractures, get a
bone density test. They also suggest that younger women who have gone through
menopause and have one or more risk factors (such as family history of spine
fractures) get tested, too.
Despite those guidelines, many physicians say that all average, healthy
women should get a bone density test when they enter menopause, says Laura
Tosi, MD, director of the bone health program at Children's National Medical
Center in Washington. That makes sense, she says, because bone loss tends to
speed up in the years after menopause, so getting a baseline idea of where you
stand as you enter menopause gives you something to compare later scans to.
And some women should get the test even earlier, Tosi says. For instance, a
woman who is 40 or so and suffers a "fragility" fracture -- a bone
break that occurs when you fall from a standing height (about 5.5 feet or less)
-- should get a bone density test, Tosi says. That type of fracture, she
reasons, doesn't occur to strong bones.
Women who have been on high-dose corticosteroid medications to treat
autoimmune disease such as lupus, along with women who have thyroid disease,
should consider a bone density test, too, Tosi says, because they are more
likely than others to have lower bone density.