Sip, Scroll, and Learn (Midlife Edition)

What Your Results Mean and Why They Matter

When I received my DEXA scan results, I was shocked.

Like many women, I knew osteoporosis existed, but I never expected to see it on my own report. Yet there it was, a diagnosis that forced me to take a closer look at my bone health.

The truth is that bone loss often happens silently. Most women don’t feel their bones getting weaker, and many don’t discover they have osteopenia or osteoporosis until after a fracture occurs.

That’s why understanding your DEXA scan is so important.

Let’s break down what this test measures, what your results mean, and what steps you can take to protect your bones during and after menopause.

What Is a DEXA Scan?

A DEXA (Dual-Energy X-ray Absorptiometry) scan is the gold-standard test used to measure bone mineral density (BMD).

The scan is painless, non-invasive, and takes only a few minutes.

Most DEXA scans measure bone density in the:

• Lumbar spine (lower back)
• Hip
• Femoral neck (upper thigh bone)

These areas are important because they are common sites for osteoporotic fractures.

Why Bone Health Matters After Menopause

Estrogen plays a major role in protecting bone.

As estrogen levels decline during menopause, bone breakdown begins to outpace bone building.

Research suggests women can lose up to 10-20% of their bone density during the first several years after menopause.

Unfortunately, bone loss typically causes no symptoms until a fracture occurs.

That’s why osteoporosis is often called a “silent disease.”

Understanding Your T-Score

The most important number on your DEXA report is your T-score.

Your T-score compares your bone density to that of a healthy young adult.

• Normal Bone Density: T-score: -1.0 or higher  This means your bone density is considered normal.
• Osteopenia (Low Bone Mass): T-score: Between -1.0 and -2.5   Osteopenia means you have lower-than-normal bone density but have not yet reached the osteoporosis range. This is often a warning sign that it’s time to take action.
• Osteoporosis: T-score: -2.5 or lower  A diagnosis of osteoporosis means your fracture risk is significantly increased and intervention is important.

Understanding Your Z-Score

Your DEXA report may also include a Z-score.

While the T-score compares you to a healthy young adult, the Z-score compares you to other people your own age.

For most postmenopausal women, healthcare providers focus primarily on the T-score.

However, a very low Z-score may suggest that additional factors are contributing to bone loss and warrant further investigation.

Which Numbers Should You Pay Attention To?

Many DEXA reports include measurements from multiple locations.

Pay attention to:

• Lumbar Spine: This area contains a high amount of trabecular bone, which is often affected early by menopause-related bone loss.
• Femoral Neck: This is one of the strongest predictors of future hip fracture risk.
• Total Hip: Provides an overall assessment of hip bone density and fracture risk.

Your healthcare provider will generally focus on the lowest T-score when determining risk and treatment recommendations.

What Causes Bone Loss?

Several factors can contribute to osteoporosis and osteopenia:

Hormonal Changes

• Menopause
• Low estrogen levels
• Early menopause

Nutritional Factors

• Low calcium intake
• Low vitamin D
• Inadequate protein intake

Lifestyle Factors

• Sedentary lifestyle
• Smoking
• Excessive alcohol intake

Medical Conditions

• Thyroid disorders
• Autoimmune conditions
• Celiac disease
• Digestive disorders affecting nutrient absorption

Medications

• Steroids
• Certain acid-blocking medications
• Some antidepressants
• Certain cancer treatments

Additional Labs Worth Checking

A DEXA scan tells you that bone loss is occurring.

Additional lab testing can help uncover why.

Consider discussing these labs with your healthcare provider:

• Vitamin D (25-OH)
• Calcium
• Parathyroid Hormone (PTH)
• Magnesium
• Thyroid Panel
• CBC
• CMP
• Celiac screening (when appropriate)

Can Osteopenia and Osteoporosis Be Improved?

Many women believe a diagnosis of osteopenia or osteoporosis means there is nothing they can do.

Fortunately, that’s not true.

While rebuilding bone takes time, several strategies may help support bone health:

Prioritize Strength Training

• Bones respond to stress.
• Resistance training sends a signal to your body to maintain and build stronger bone tissue.

Eat Enough Protein

• Protein provides the building blocks needed for healthy bones.

Optimize Vitamin D

• Vitamin D helps your body absorb and utilize calcium effectively.

Support Calcium Intake

• Focus on food sources first whenever possible.
• Improve Balance and Stability
• Preventing falls is just as important as improving bone density.

Address Root Causes

• If nutrient deficiencies, hormone imbalances, digestive issues, or thyroid problems are contributing to bone loss, those issues should be addressed.

When Should Women Get a DEXA Scan?

Many organizations recommend screening at age 65.

However, earlier testing may be appropriate if you:

• Are postmenopausal
• Have a family history of osteoporosis
• Have experienced a fracture
• Have low body weight
• Have been on steroid medications
• Have autoimmune disease
• Have low vitamin D
• Entered menopause early

Talk with your healthcare provider about what is appropriate for your individual situation.

One Last Thought

I often tell women that osteoporosis doesn’t happen overnight.

It develops over years, often without symptoms.

That’s why understanding your DEXA scan can be one of the most important steps you take for your long-term health.

Your bones support you every day.

They deserve the same attention you give your heart, hormones, and metabolism.

The sooner you understand your bone health, the more opportunities you have to protect it.

Wishing you health and happiness,

Martine