Osteoporosis is one of the most common health conditions affecting women after menopause. Yet most doctors do not order DEXA scans—the gold standard test for measuring bone density—until we turn 65. By then, we may have already lost significant bone mass, and our window for non-drug intervention will be closed.

Here’s what we need to know: Women lose bone at the highest rates during the few years leading up to menopause and for about five years after our final period. It’s during perimenopause and the early years of postmenopause that we should be checking our bone density—not decades later.

Why Early Detection Matters

When we catch bone loss early, while it’s still mild (a condition called osteopenia), our interventions are most effective. We can actually slow or even prevent further loss with lifestyle changes, exercise, targeted supplements, and hormone therapy.

But once we’ve already developed full-blown osteoporosis? At that point, osteoporosis becomes a chronic, lifelong condition requiring ongoing management.

Our Critical Window

So let’s talk timing. The 2-3 years before our final menstrual period and the first 5 years after are when we need to be most vigilant. Bone loss accelerates during these years, primarily because of declining estrogen levels—this is when we’re losing the most bone.

If our bone density is already low going into menopause (osteopenia), our chances of developing osteoporosis by age 65 increase significantly. This is exactly why early screening matters so much.

Other Reasons for Early Screening

If you have risk factors for osteoporosis, this is another reason to screen early.
Risk factors include:
History of previous fracture
Family history of osteoporosis
Being thin (<127 lbs)

The Estrogen Connection

Here’s something important: estrogen replacement is one of the most effective ways to prevent and treat bone loss. If you’ve been on the fence about menopausal hormone therapy, and you discover you have osteopenia or are losing bone, that’s a compelling reason to consider hormone replacement.

What We Can Do Right Now

Ask your doctor to order a DEXA scan at the onset of menopause. Don’t wait until 65. If your insurance won’t cover it, don’t let that stop you—there are surprisingly affordable cash-pay options. Here in Milwaukee, for example, you can get a DEXA scan for just $75 at UWM!

Our bones deserve proactive care, not reactive management. Let’s take charge of our bone health while we have the power to make a real difference.

References:

McClung, M.R. “An Update on Prevention and Treatment of Postmenopausal Osteoporosis.” Presented at Special & Current Topics in Women’s Health, Institution of Women’s Health and Integrative Medicine, January 23, 2026.

Trabecular Bone Score Declines During the Menopause Transition: The Study of Women’s Health Across the Nation 
https://pubmed.ncbi.nlm.nih.gov/31613958/

Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women’s Health Across the Nation
https://pubmed.ncbi.nlm.nih.gov/21976317/