Osteoporosis Screening and Treatment

Women face unique health challenges when it comes to maintaining strong bones. Osteoporosis is common in postmenopausal women. This is due to low estrogen levels after menopause. Estrogen is vital for bone density. Its decline can accelerate bone loss. This makes osteoporosis a major concern for women’s health. Learn more about Osteoporosis screening.

What is Osteoporosis?

Osteoporosis is when your bones become weak, brittle, and more likely to break. This happens when the body loses bone material faster than it can replace it.

Over time, the loss causes bones to become porous, like sponges. Their structure weakens, making them more prone to fractures, even from minor bumps or falls.

Often referred to as the ‘silent disease,’ osteoporosis typically doesn’t show any symptoms until a bone breaks. By then, the condition is already advanced. That’s why early testing and prevention are so important.

Who is at Risk for Osteoporosis?

Osteoporosis can affect anyone, but some groups are at a higher risk:

• Women over 65. After menopause, a drop in estrogen levels accelerates bone loss.
• Postmenopausal women at any age with certain risk factors like family history, low body weight, or smoking.
• People who take certain medications, like long-term steroids (glucocorticoids).
• People with rheumatoid arthritis, celiac disease, thyroid issues, or vitamin D deficiencies.

Signs and Symptoms of Osteoporosis

In its early stages, osteoporosis doesn’t usually cause noticeable symptoms. However, as the condition progresses, you may experience:

• Loss of height over time
• A stooped or hunched posture
• Back pain, which may be caused by fractures in the spine called vertebral compression fractures
• Bones that break easily, even from minor falls, bending, or coughing. The bones most often affected include the following:
  • Hip
  • Wrist
  • Spine

Why is Osteoporosis Testing Important?

Osteoporosis often goes undiagnosed until a fracture happens. Early testing allows doctors to identify bone loss, assess your risk of fractures, and start treatment to prevent further bone weakening.

The U.S. Preventive Services Task Force recommends that all women over 65 get a bone density screening. If you’re under 65 but have risk factors like a family history of osteoporosis, smoking, or low body weight, your doctor may suggest getting screened as well.
Menopause can lead to rapid bone loss, particularly in the first 5-7 years after your last menstrual period.

In addition, pregnancy and breastfeeding temporarily decrease bone mineral density. Although it often recovers afterward, women who enter menopause with lower baseline bone density may be at greater risk for osteoporosis.

Your OB/GYN can help identify risk factors such as:

• A family history of osteoporosis
• Low body weight
• Smoking
• Early menopause (before age 45)

Screening can lead to interventions to help you regain bone density. This helps you avoid the risks of untreated osteoporosis, including:

• Hip, spine, and wrist fractures
• Spinal compression
• Reduced mobility
• Persistent pain
• Secondary issues like muscle weakness and respiratory problems

Types of Tests for Osteoporosis

Doctors use several tests to check for osteoporosis, with the most common being:

Dual-energy X-ray Absorptiometry (DEXA)

This is the gold standard for measuring bone mineral density (BMD). During the test, you’ll lie on a cushioned table while a scanner passes over your body. The DEXA scan is quick and painless. It measures bone density at key fracture sites like your spine and hips.

Your results are reported as a T-score:

• -1.0 or above: Normal bone density
• Between -1.0 and -2.5: Low bone mass (osteopenia)
• -2.5 or lower: Osteoporosis

Peripheral DEXA

This test measures bone density in areas like the wrist or heel. While portable and convenient, it’s less reliable for predicting fracture risk than a DEXA of the spine and hip.

Quantitative Ultrasound (QUS)

This test evaluates bone quality, usually in the heel. It doesn’t measure BMD directly, so a DEXA scan may still be needed for diagnosis.

Osteoporosis Treatment

The goal of treatment is to slow down bone loss, strengthen existing bone, and reduce the risk of fractures. Treatment typically includes medications, lifestyle changes, and nutrition.

Medications

Doctors may prescribe specific medications based on your risk and overall health:

• Bisphosphonates can help slow bone loss and reduce the risk of fractures.
• Calcitonin helps prevent bone breakdown in postmenopausal women who cannot tolerate other treatments.
• Hormone, or estrogen therapy, is effective for preventing bone loss in postmenopausal women, though it carries some risks for some women.
• RANK (Receptor Activator of Nuclear factor Kappa-Β) ligand inhibitors slow bone loss and improve bone strength, especially in severe cases.
• Parathyroid hormone analogs promote new bone formation for individuals at high risk for fractures.

Nutrition

Eating a diet rich in calcium, vitamin D, and protein can help strengthen your bones:

• Calcium: Found in low-fat dairy products, leafy greens, and fortified foods like cereal or orange juice.
• Vitamin D: Essential for calcium absorption. You can get it from sunlight, fatty fish, egg yolks, and fortified milk.

Your doctor may recommend supplements if you can’t get enough from food.

Exercise

Regular physical activity is one of the best ways to maintain bone strength and reduce fracture risk. The most effective exercises include:

• Weight-bearing exercises like walking, jogging, dancing, and climbing stairs.
• Resistance training using weights or resistance bands.
• Balance exercises to improve stability and prevent falls.

Lifestyle Changes

Making minor adjustments can protect your bones, such as:

• Quitting smoking
• Limiting alcohol to no more than one drink per day.
• Fall-proofing your home by removing clutter, improving lighting, and installing grab bars in the bathroom.

Osteoporosis FAQs

1. Can osteoporosis affect younger women?

Yes, although less common, osteoporosis can occur in younger women due to genetic conditions, hormonal imbalances, eating disorders, or prolonged use of certain medications like steroids.

2. Is osteoporosis reversible?

While osteoporosis cannot be fully reversed, treatments can slow down bone loss, increase bone density, and significantly reduce the risk of fractures. Combining medications, proper nutrition, and exercise offers the best chance of effectively managing the condition.