Postmenopausal Women without Osteoporosis May Not Benefit from Repeat Bone Scans
We can’t say enough about bone health and prevention of osteoporosis and fractures, and a bone mineral density (BMD) test, or bone scan, is an important way to monitor the strength of your bones. Because a BMD test can be so valuable, it’s helpful to know when you can most benefit from initial and repeated screening. According to recent research, if you’re a postmenopausal woman between age 50 and 64 and have had a normal scan (no osteoporosis), you may not need to be rescreened before age 65.
The National Osteoporosis Foundation (NOF) (nof.org) recommends a BMD test for all women age 65 and older, anyone who’s broken a bone after age 50, women of menopausal age with risk factors, and postmenopausal woman under age 65 with risk factors. Risk factors include family history of osteoporosis, low body weight or being small and thin, or having had broken bones or height loss.
So where does this leave you if you’re a postmenopausal women under age 65 without risk factors for osteoporosis? According to the NOF guidelines, you may not need a bone scan. But many prevention-minded women in this demographic still get scanned. So we’re understandably curious about what results might say about their fracture risk and whether they can benefit from repeated testing before age 65.
A recent study included about 4,000 postmenopausal women, ages 50 to 64 years, who didn’t have a hip or vertebral fracture at the start of the study. Participants underwent BMD testing between 1993 and 2005 and were followed through 2012. They were analyzed in two separate groups according to osteoporosis status: women with osteoporosis at first BMD test and women without osteoporosis at first BMD test.
Women without osteoporosis on their first BMD test had a very low risk of major fracture during follow-up compared with women who had osteoporosis on their first test. For example, the researchers estimated that for those without osteoporosis, it would take almost 13 years for 1 percent of women ages 50 to 54 to experience a fracture and almost eight years for 1 percent of women ages 60 to 64. They estimated, however, that 1 percent all women with osteoporosis would experience a fracture within three years.
Based on these findings, postmenopausal women under ages 50 to 64 without osteoporosis according to a BMD test may not benefit from repeated screening before age 65. Despite the many benefits to BMD testing, it’s helpful to know when testing is most beneficial. You can save time and cost (particularly if your insurance doesn’t cover BMD density tests for your age and risk profile) and know that this important screening is there for you when the time is right. On the other hand, for postmenopausal under age 65 who do have osteoporosis, these findings remind us of the value of regular testing.
Gourlay ML MD, Overman RA, Fine J, et al. Baseline Age and Time to Major Fracture in Younger Postmenopausal Women. Menopause [early online publication]. October 2014.