For the past 15 years, we doctors have been pushing the pedal to the metal when it comes to diagnosing and treating osteoporosis. The message seemed to be “it’s never to early to screen for thin bones.”
But the trend towards early and frequent screening has eased somewhat, and will probably ease even more in light of a new study in this week’s New England Journal of Medicine.
The study finds when women age 65 or older are screened for osteoporosis and their bones are A-OK, it is then A-OK to wait up to another 15 years before screening again. That’s because, for the vast majority of women, osteoporosis is a very slooooooooow disease. Meaning if you’ve got good bones, you’re probably going to have good bones for a long time.
We used to start screening women in the 50s for thin bones. Now the guidelines say the first screen should be at age 65 — unless there’s something else going on.
For example, women with a strong family of osteoporosis, very thin women, women who smoke or women who have had their ovaries removed at a young age (or undergone an early menopause) are among those who should probably be screened before 65.
But there is no “one size fits all” for this special group when it comes to what age to start bone density screening. It’s a good topic to discuss with your doctor.
One final point: The trend towards frequent screening really seemed to start when drugs to treat osteoporosis came along beginning around 1995.
Since then we’ve learned that these drugs are good, but not perfect. They do not prevent osteoporosis. You can’t stay on them forever if you do have osteoporosis. And they can have some fairly heavy-duty side effects. Keep it in mind when it comes to screening and treatment.