Osteoporosis
Bone Density Testing
excerpted from: "Strong Women, Strong Bones"
by Miriam E. Nelson, Ph.D.
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A generation ago, the only practical way to find out if you were losing bone mass was to break a bone.  Now you can take a simple fifteen-minute test and get a precise measure of your bone density.  You can learn if your bones are dangerously weak without suffering a fracture, while there's still time for preventative measures.

Exciting as this advance is, I'm not suggesting that every woman rush out and have a bone density test right now.  This chapter will help you decide when you need to be tested.  I'll also describe the available procedures so you know what the options are and what to expect.

Do I need a Bone Density Test?

I hear this question often from concerned women.  The answer depends on your age, your risk factors, and whether you're being treated for bone loss.  We don't yet have a single set of guidelines, though there's considerable agreement among groups that have issued recommendations, including the National osteoporosis Foundation, the American College of Obstetrics and Gynecology, and the American Association of Clinical Endocrinologists.  The advice below is based on these guidelines.  However, I believe that testing can benefit other women as well.

If you are about to start
treatment for bone loss

A preliminary bone density test is standard practice before treatment starts.

• First, the test could help determine if you need medication.
• In addition, the test provides a baseline that allows you and your doctor to monitor the effectiveness of the treatment.

If you have symptoms
that suggest osteoporosis

Regardless of your age, ask your doctor about testing if you have symptoms that might indicate bone loss:

• You've had a fracture that suggests low bone density, because it was not related to a severe trauma.
• You've lost more than an inch and a half in height, or have developed curvature of the spine.
• You have acute or chronic pain in the middle to upper back.

Ironically, testing is often NOT recommend
for an individual whose osteoporosis is readily diagnosed from age and sever symptoms-  for instance, a woman in her nineties who has a history of fractures in her spine and has just broken her hip.  The reason: Her doctor already knows that she needs treatment for osteoporosis, so test results wouldn't affect her care.

If you have significant risk factors

Some guidelines suggest testing for women in their twenties, thirties, or early forties if they have special risk factors

• You've had your ovaries removed
• You have a history of prolonged or chronic menstrual irregularities caused by a medical problem or an eating disorder
• You have a medical condition that causes bone loss
• You take medication that harms bones, or are about to start such a medication.

Getting tested now gives you precious extra time to protect your bones.  If you have low bone density this early in your life, you might want to talk to your doctor about medication as well as nutrition and exercise.

If you're in perimenopause
Though most guidelines don't recommend testing at this time, I think it provides valuable information.  As you approach menopause, bone loss acceleration.   A baseline test will help you decide about hormone replacement and other protective measures during these critical years.

If you've gone through menopause
Guidelines generally recommend bone density testing for women over age 60 or 65, and for younger postmenopausal women who have one or more additional risk factors.  But ALL women are at greater increased risk for osteoporosis after menopause.  Therefore I urge you to consider testing if you're in menopause and haven't already been tested.

Bone density testing is particularly helpful if you're deciding about hormone replacement therapy (HRT).  Also, if you've been on HRT and are thinking of stopping, you should know the condition of your bones.

to the interview with Miriam E. Nelson, Ph.D.

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