Osteoporosis is one of the most common – and most preventable – conditions affecting women's health, and DEXA scanning exists to identify it early.
Osteoporosis develops without symptoms. There is no pain, no warning, nothing that feels different from one day to the next. Bone density decreases gradually over years, and for most women the first indication that something is wrong is a fracture.
This is more common than many people realise. Osteoporosis affects an estimated 200 million women worldwide, and one in three women over 50 will experience a fracture related to bone loss during her lifetime. In Sweden – one of the countries with the highest rates of hip fractures in the world – around 70,000 such fractures occur every year. A hip fracture carries serious consequences: studies suggest that up to 30 percent of patients do not survive the following year.
The good news is that bone loss can be detected early. And early detection makes a real difference.
It starts earlier than most people know
The assumption is that bone loss belongs to old age. For women, it starts decades earlier.
Oestrogen plays an important role in maintaining bone density. When oestrogen levels begin to decline during perimenopause, bone loss accelerates. In the first five to seven years after menopause, women can lose up to 20 percent of their bone mass.
This happens at a time when most women feel otherwise healthy. And because there are no symptoms, it often goes unnoticed.
Why it goes undetected
In most healthcare systems, bone density is not routinely measured until after a fracture has occurred. By that point, the focus shifts from prevention to management.
This is not for lack of tools. DEXA scanning has been the clinical standard for measuring bone density for decades. It is non-invasive, takes less than fifteen minutes and can identify reduced bone density years before a fracture occurs.
A DEXA scan produces a T-score, which compares your bone density to that of a healthy young adult. A score between -1 and -2.5 indicates osteopenia – reduced bone density that raises fracture risk. Below -2.5 indicates osteoporosis. In both cases, knowing where you stand opens up meaningful options for what to do next.
What a DEXA scan can do – and what else helps
Bone loss is not simply something that happens to you. Identified early through DEXA scanning, there is quite a lot that can influence its progression.
Resistance training is one of the most well-documented tools for maintaining bone density. Adequate calcium and vitamin D intake matters. For some women, hormone therapy during perimenopause can significantly reduce the rate of bone loss. These interventions are considerably more effective when started early – based on an actual assessment of where your bone health stands today.
Women with risk factors for osteoporosis – including early menopause, family history, low body weight or prolonged periods of low oestrogen – should discuss earlier assessment with their doctor. At EndoHealth, bone density is assessed as part of a comprehensive health mapping, giving a complete picture of where a woman stands and what can be done about it.
In summary
The tools for detecting bone loss early exist and are clinically well validated. For women with risk factors, earlier assessment opens a meaningful window for intervention. Understanding where you stand today is a practical step towards staying healthier for longer.
Sources
Kanis JA, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women.Osteoporosis International, 2019.
Eastell R, et al. Postmenopausal osteoporosis. Nature Reviews Disease Primers, 2016.
Compston JE, McClung MR, Leslie WD. Osteoporosis. The Lancet, 2019.
Bliuc D, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA, 2009.
Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. The Lancet, 2002.
Riggs BL, Khosla S, Melton LJ. Sex steroids and the construction and conservation of the adult skeleton. Endocrine Reviews, 2002.
Kohrt WM, et al. Physical activity and bone health. Medicine & Science in Sports & Exercise, 2004.
