I got my first DEXA (the gold standard test used to assess bone density) scan a month ago. I was pretty confident it would come back looking good—for a variety of reasons.
Side note: I had to ask for it. It wasn’t offered. In fact, it’s never been offered to me—and I’m no spring chicken. Medicare does cover a DEXA scan once a woman turns 65, but that’s often too late since the greatest amount of bone loss happens during the first 5–8 years after menopause.
Let’s do the math: if the average woman enters menopause around age 50, that means most women don’t get their first DEXA until 15 years after the window of fastest bone loss has passed. Ideally, a woman’s first DEXA scan should happen as she enters menopause—at least to establish a baseline and at the outside five years into her menopausal years.
Some insurances do cover a DEXA earlier if you’re genetically predisposed, have been on long-term steroids, or went through early menopause. But again—you’ll probably have to ask.
Back to me 🙂
My scan came back showing that my spine looks great, and my hip is just barely in the osteopenia range at -1.1 (the cutoff for “normal” is -1.0). I’m still in the green, and my FRAX risk of fracture over the next 10 years is essentially zero.
So, you can imagine my surprise—and dismay—when my doctor immediately prescribed a bisphosphonate.
All I could think was: Seriously?
There was:
- No discussion of diet, exercise, stress, or vitamin D, K and magnesium status and supplementation.
- No consideration of my history or lifestyle (this was a phone visit—she knew nothing about the person on the other end).
- No suggestion to wait and recheck in a year to see if anything changes.
- No context: this was my first DEXA scan. We have no idea when this bone loss occurred—early in menopause, recently, slowly over time? Who knows!
- No inquiry into family history of osteoporosis (which I don’t have).
- And no mention of hormone replacement therapy (HRT)—an FDA approved therapy to prevent bone loss. Estrogen prevents bone loss!
At age 67, with minimal bone loss, being handed a bisphosphonate prescription without any conversation feels—not to be dramatic—a bit reckless. Honestly, I’d call it borderline malpractice. Yes, strong words—but I stand by them.
Now let me be clear: I’m not anti-medication. Medications absolutely have their place. But they shouldn’t be the first line of treatment for most chronic conditions—and certainly not handed out like candy.
Here’s why bisphosphonates should not be taken lightly. Side effects can include:
- Spontaneous fractures of the femur—leading to falls and a broken hip.
- Jawbone necrosis—rare, but possible, especially after prolonged use.
- Digestive issues—which I already struggle with.
- Reduced bone quality—the bones may appear denser on scans, but actually become more brittle over time.
And what about an exit strategy. These drugs should not be used for more than 3–5 years, as long-term use can do more harm than good. When I reach age 71, what then would be the strategy?
Our bones aren’t something to ignore. Osteoporosis robs people—both men and women but especially women—of mobility and independence.
Each year in the U.S., osteoporosis leads to around 2 million fractures. And among older adults, 14–36% of those who experience a hip fracture will die within a year due to complications. The rates are even higher among those with dementia or in nursing homes.
Bone health matters.
I’m curious and would like to know from you!
- Have you had a DEXA scan before age 60?
- If you’ve been diagnosed with osteopenia or osteoporosis, what options were you given?
- Was HRT ever offered as a treatment?
- Were the risks of bisphosphonates explained?
- Did anyone talk to you about lifestyle changes that support bone health?
- Have your vitamin D levels been checked lately?
Inside the Grace in Transition Course, we walk you through these strategies step-by-step.
Because when women understand what’s happening in their bodies, and know what to do about it—everything changes.
You deserve that kind of clarity.
And you don’t have to do it alone.
To learn more about this amazing course and get on the wait list Click here!