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During menopause, the ovaries stop producing eggs, which decreases levels of estrogen. This usually occurs between the ages of 45-55. After a year without a menstrual period a woman is considered post-menopausal.
Estrogen is a hormone that maintains bone density and decreases fracture risk, so reduced levels can lead to low bone density and osteoporosis. According to the Menopause Foundation of Canada, osteoporosis poses a serious health threat for postmenopausal women:
The effects of low bone density can be mitigated with a balanced diet rich in calcium and vitamin D, a healthy lifestyle without smoking or excessive alcohol intake, and physical activity that includes weight-bearing, strength-training, and balance exercises. Medication may also be prescribed to improve bone health.
The older you are, the more likely you are to have low bone mass, sometimes called osteopenia. Low bone mass can lead to osteoporosis – a disease which makes bones more porous and brittle, and can cause fractures, pain, and deformities.
The most accurate way to determine the density of your bones is to have a bone mineral densitometry (BMD) exam, also known as dual-energy X-ray absorptiometry or DEXA scan. A first (baseline) BMD exam is often taken at around age 50 and then subsequent exams may be recommended every two years.
A bone mineral densitometry exam is a low dose X-ray scan that measures the density of minerals (such as calcium) in your bones. It is used to help determine the strength of your bone and whether you are at risk of a bone fracture or if you have osteoporosis.
Low bone mass and osteoporosis rarely cause symptoms, which means you may not discover you have one of them until you sustain a painful fracture. This is why early detection is important, as well as being aware of your risks.
Women are at higher risk of developing osteopenia or osteoporosis due to having smaller or less dense bones than male bones, plus the increased risk that occurs during menopause. Because osteoporosis is more common in women than men, it is often thought of as a women’s disease. However, men frequently get osteoporosis.
Other risk factors for bone loss include having a diet low in calcium, an inactive lifestyle, smoking, certain diseases associated with malabsorption issues and hyperparathyroidism. Taking certain medications like glucocorticosteroids can cause bone loss as well.
Regular bone density testing is recommended to monitor bone loss. A BMD exam is not usually required until you are 50 years of age or older, unless you fall into a high-risk category.
A bone mineral densitometry exam sends a low-dose X-ray beam through the spine, hip, or forearm. Special computer software subtracts the soft tissue information and displays the bone density measurements. Generally, the higher the mineral content, the denser the bone is. The denser the bones are, the less likely they are to fracture.
During your BMD exam, you will need to avoid wearing clothes with buttons, metal buckles, and zippers near your spine and hip as they may interfere with the scan. You will be weighed and measured, then positioned on the table by the technologist. You will be asked to hold very still while the scanner moves over the area being examined. You may be scanned more than once.
Measurements must be very precise. Since measurements can vary between machines, repeat tests must be taken on the same machine or a new baseline will be created.
Watch the video: What is bone density screening?
If you are age 50 or older, your bone mineral density test result will be a T-score. A T-score is the difference between your bone mineral density and the average bone mineral density of a healthy young adult.
If you are younger than 50, your bone mineral density test result will be a Z-score. The Z-score is the difference between your bone mineral density and the average bone mineral density for healthy people of your age and sex.
To determine if bone density testing is right for you, you will need to discuss your risk factors and family history with a health care practitioner, who would then provide a requisition for this procedure if it’s needed. You can then call to book an appointment with our Contact Centre, and they will explain how to prepare for your exam.
Please visit bone mineral densitometry services for more information about what happens during this exam and how to prepare.
Once your exam is completed, your images will be reviewed by a specialized radiologist who will compile a report that is sent to your doctor within two business days, sooner for urgent requests. Mayfair Diagnostics is owned and operated by over 50 specially trained radiologists, which allows for an expert review of your imaging by the applicably trained radiologist.
Your doctor will review your images and the report from the radiologist and discuss next steps with you, such as a treatment plan or the need for further diagnostic imaging or lab tests to ensure an accurate diagnosis.
Mayfair Diagnostics has 13 locations across Calgary and one in Cochrane that offer bone mineral densitometry services.
REFERENCES
John Hopkins Medicine (2024) “Osteoporosis: What You Need to Know as You Age.” hopkinsmedicine.org. Accessed August 26, 2024.
Ji, M. & Yu, Q. (2015) “Primary osteoporosis in postmenopausal women.” Chronic Diseases and Translational Medicine. 2015 Mar; 1(1): 9–13. Accessed August 26, 2024.
Menopause Foundation of Canada (2024) “Bone Health – Osteoporosis.” menopausefoundationcanada.ca. Accessed August 26, 2024.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (2023) “Bone Mineral Density Tests: What the Numbers Mean.” niams.nih.gov. Accessed August 26, 2024.
OrthoInfo (2021) “Healthy Bones at Every Age.” orthoinfo.aaos.org. Accessed August 26, 2024.
Osteoporosis Canada (2024) “Men and Osteoporosis.” osteoporosis.ca. Accessed August 26, 2024.
Osteoporosis Canada (2024) “Facts and Stats.” osteoporosis.ca. Accessed August 26, 2024.
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