Updated Guidelines for Osteoporosis Screening

New recommendations on screening women for bone loss are available for the first time since 2002. The new guidelines call for all women to be screened by age 65 and younger women determined to be at greater risk for developing the disease. There is no age beyond which screening becomes unnecessary; fracture risk continues to increase with age.

Predicting an individual's risk for osteoporotic fracture can be accomplished using the FRAX calculator as developed by the World Health Organization and the National Osteoporosis Foundation. Patients can go on line and calculate their risk, which estimates the 10-year fracture risk based on various parameters. Results of dual-photon x-ray absorptiometry scans add critical information. Perhaps you have had such a scan at Tyler Obstetrics & Gynecology.

The recommendation regarding frequency of scanning (although data is lacking) is every two years if any bone loss (osteopenia) is detected or risk factors change in a way as to increase the women's risk for fracture.  An interval of at least two years is needed to assess a change in bone mineral density (BMD) for a more precise prediction of fracture risk.

It is estimated that 12 million Americans will develop osteoporosis each year. Fifteen per cent will develop a hip fracture, 25% will develop a vertebral fracture. Of postmenopausal women with osteoporosis, HALF will have some kind of fracture. Hip fractures in women over age 65 result in a mortality (death rate) of 20% within the first year after fracture.

Postmenopausal women under age 65 who do not take hormone therapy (HT) need to be screened and their diet supplemented with calcium (as calcium CITRATE) and vitamin D (preferably D3). Those women who are taking advantage of HT still need to ask their medical provider about the amounts of calcium and vitamin D that is recommended considering their individual situation.

Take some time to look on line and learn about FRAX. Next time you are in our office, ask about whether setting up a BMD scan is appropriate for you. It is generally recommended that follow up scans be done on the same machine so that comparisons of scans done previously can be made even if minimal changes are noted. It is the trend in the bone densities that is important in guiding your medical provider to make the most appropriate recommendation for you to follow.