Check your bone density, health after menopause with these 6 expert-approved tests and tools

Blood tests are used to measure levels of essential nutrients and markers that influence bone health, such as calcium, vitamin D, alkaline phosphatase, and parathyroid hormone (Image: Canva)

Post-menopause, women face a heightened risk of bone health issues due to hormonal changes, particularly the decrease in estrogen, which plays a key role in maintaining bone density. The significant drop in estrogen levels after menopause leads to an accelerated loss of bone mass, which increases the likelihood of developing osteoporosis—a condition that makes bones more brittle and prone to fractures. This bone density loss is most rapid in the first few years post-menopause, underscoring the need for early intervention and regular monitoring.

Ageing also naturally affects bone health by reducing bone formation and increasing the rate of bone resorption. Lifestyle factors, such as a poor diet, lack of physical activity, smoking, and excessive alcohol consumption, can further exacerbate the risk of bone deterioration.

Dr Kavita Deshmukh, a Senior Consultant in Gynecology and Women's Health at Sunshine Medical Center, Pune, says that regular check-ups, maintaining a healthy lifestyle, and being aware of the signs of bone weakening are crucial steps in preserving bone health.

Also read | 8 health tips to keep bones strong, reduce osteoporosis risk

She suggests six ways to monitor your bone health after menopause.

Bone Density Test (DXA Scan)

• What it is: A bone density test, or dual-energy X-ray absorptiometry (DXA) scan, is a non-invasive procedure that measures bone mineral density (BMD). The scan focuses on areas most vulnerable to fractures, such as the hip and spine.
• Why it's important: DXA scans are crucial in diagnosing osteoporosis and assessing the risk of fractures. The test compares your bone density to both a healthy young adult (T-score) and individuals of the same age (Z-score). This comparison helps determine the extent of bone loss and informs treatment decisions.
• Frequency: Postmenopausal women, especially those with risk factors like a family history of osteoporosis, low body weight, or previous fractures, should have a DXA scan every one to two years to monitor bone health and make adjustments to their care plan if necessary.

• What they are: Blood tests are used to measure levels of essential nutrients and markers that influence bone health, such as calcium, vitamin D, alkaline phosphatase, and parathyroid hormone.
• Why they're important: Calcium and vitamin D are vital for bone strength. Blood tests can reveal deficiencies that may lead to bone weakening. Elevated levels of alkaline phosphatase or parathyroid hormone can indicate increased bone turnover, which is associated with bone loss.
• Frequency: These tests should be done regularly, especially if you have risk factors for osteoporosis or if you’ve already been diagnosed with low bone density.

• What it is: The Fracture Risk Assessment Tool (FRAX) is an online calculator developed by the World Health Organization. It evaluates your 10-year probability of sustaining a major osteoporotic fracture or hip fracture.
• Why it's important: FRAX takes into account multiple factors, including age, sex, weight, height, history of fractures, family history, lifestyle habits like smoking and alcohol consumption, and the use of certain medications like glucocorticoids. This comprehensive assessment helps doctors estimate fracture risk and guide treatment decisions.
• When to use it: Use the FRAX tool during your regular medical check-ups, especially if you're over 50 or have risk factors for osteoporosis, to assess whether additional interventions are needed.

Physical Exam and Medical History

• What it is: A thorough physical exam, combined with a review of your medical history, is a simple yet essential step in evaluating your bone health. During the exam, your doctor will check your posture, height, and overall physical condition, and ask about lifestyle factors that could impact bone health.
• Why it's important: Changes in posture or height can indicate vertebral fractures, while factors like smoking, alcohol use, or a sedentary lifestyle increase the risk of bone loss. Your doctor can also review your medication history to see if any drugs you're taking could affect bone health.
• Frequency: Regular physical exams should be conducted at least annually, with more frequent check-ins if you have existing bone health concerns.

• What it is: This involves evaluating your diet to ensure you’re getting adequate amounts of calcium and vitamin D, and adjusting your intake through diet or supplements if necessary.
• Why it's important: Calcium is critical for maintaining bone density, while vitamin D helps the body absorb calcium. Deficiencies in either can accelerate bone loss, making fractures more likely. For adults over 50, the recommended daily intake is 1,200 mg of calcium and 600-800 IU of vitamin D.
• When to assess: Monitor your dietary intake regularly, and consult with a healthcare provider to determine if supplements are needed.

• What it is: This involves assessing your current level of physical activity and ensuring you're incorporating weight-bearing and muscle-strengthening exercises into your routine. Activities such as walking, jogging, dancing, and resistance training are particularly effective.
• Why it's important: Regular physical activity helps maintain bone density and strengthens muscles, which can reduce the risk of falls and fractures. Weight-bearing exercises, like walking or strength training, stimulate bone formation, while balance exercises improve coordination, reducing the chance of falls.
• Frequency: Aim for at least 30 minutes of weight-bearing exercise most days of the week. If you have osteoporosis or are at high risk, consult your doctor before starting a new exercise routine.

Tips for maintaining bone health post-menopause

• Adequate calcium intake: Consume 1,200 mg of calcium daily through a combination of dietary sources (dairy, leafy greens, fortified foods) and supplements if needed.
• Sufficient Vitamin D: Aim for 600-800 IU of vitamin D daily through sunlight exposure, diet (fatty fish, fortified foods), or supplements.
• Regular exercise: Engage in weight-bearing and muscle-strengthening exercises to maintain bone strength.
• Avoid smoking and limit alcohol: Both smoking and excessive alcohol weaken bones, increasing the risk of fractures.
• Medications: If you're at high risk for osteoporosis, consult your doctor about medications that may help prevent bone loss, such as bisphosphonates or hormone replacement therapy.