Bone mineral density naturally declines with age, especially after menopause. Because weaker bones lead to fractures, medical professionals emphasize regular bone health evaluations. Dual-energy X-ray absorptiometry (DEXA) is the most common bone density imaging test used for a thorough bone health check. A DEXA scan uses low-dose X-rays to precisely measure bone mineral density (BMD) at key sites (typically the hip and spine). BMD testing is a vital component in the diagnosis and management of osteoporosis because it correlates with bone strength and predicts fracture risk. A DEXA scan for bone health can reveal whether bones are normal, osteopenic, or osteoporotic, helping patients take early action to strengthen their skeletons.
Who Should Be Screened and When
Bone density screening is not done for everyone. US guidelines recommend a regular osteoporosis screening schedule starting in later adulthood. The US Preventive Services Task Force (USPSTF) advises that all women age 65 and older receive a central DEXA bone density test to prevent fractures. Younger postmenopausal women (under 65) should also be tested if they have one or more osteoporosis risk factors, such as smoking, low body weight, or a family history of hip fracture. In men, the evidence is less clear. Current guidelines say there is insufficient data to recommend routine screening for all men. However, many clinicians still consider DEXA for men over 70 or those with significant risk factors. Routine health screening for bones involves reaching out to your doctor if you fall into these risk categories: extreme thinness, steroid use, prior fractures from minor falls, or certain medical conditions. Schedule that first DEXA scan appointment at the recommended age to establish a baseline for future comparisons.
How Often to Repeat a DEXA Scan
After an initial baseline scan, doctors plan follow-up tests based on the results and risk factors. The DEXA scan frequency depends on your bone density and risk profile. In high-risk patients, retest roughly every 1–2 years to monitor bone loss. Repeat DEXA scans should occur no more than every 12–24 months. This means that if you begin a treatment to strengthen your bones, expect a follow-up scan in about a year to measure its effect, and then perhaps every two years thereafter. Lower-risk individuals may wait longer between scans. This strategy ensures changes are caught without unnecessary radiation exposure from overly frequent scans.
Understanding DEXA Results and Initial Management
After a DEXA scan, your physician will explain the numbers and next steps. The scan report gives a T-score and a Z-score at each measured site. A T-score compares your bone density to that of a healthy young adult. A T-score of -1.0 or above is considered normal; between -1.0 and -2.5 indicates osteopenia (low bone mass); and -2.5 or below defines osteoporosis. If your DEXA scan for bone health shows a T-score in the osteoporosis range (<– 2.5), or if you have already had a fragility fracture, guidelines recommend initiating treatment. Treatments may include:
- Nutritional Support for Bone Health: Adequate intake of calcium and vitamin D forms the foundation of any treatment plan when osteoporosis is detected. Calcium strengthens bone tissue, while vitamin D improves calcium absorption and helps regulate bone turnover. Doctors often recommend dietary adjustments, such as increasing dairy products, leafy greens, or fortified foods, in addition to supplementation if needed. Personalized dosing ensures that patients receive the right balance without exceeding safe levels. Together, these nutrients create a baseline of support that allows medications and lifestyle modifications to work more effectively.
- Pharmaceutical Interventions: For patients at higher risk of fractures, physicians may prescribe medications such as bisphosphonates, selective estrogen receptor modulators, or newer biologic treatments that slow bone breakdown or stimulate bone formation. These drugs work at a cellular level, helping to preserve or even rebuild bone density over time. Regular monitoring through follow-up scans ensures that these therapies are having the intended effect, and doctors can adjust prescriptions as needed.
- Lifestyle and Functional Adjustments: Weight-bearing activity remains the cornerstone of this approach because bones respond to mechanical stress by becoming denser and stronger. Simple activities such as brisk walking, stair climbing, or dancing stimulate bone tissue in a way that helps preserve density, while resistance training with bands, free weights, or machines targets muscle groups that support skeletal alignment. This dual benefit enhances overall stability and reduces the likelihood of falls, which are one of the leading causes of fractures in older adults. For individuals unable to engage in higher-impact exercise, low-impact alternatives like tai chi and yoga are highly effective at improving balance, flexibility, and core strength, which further lowers the risk of injury. Another lifestyle priority is sleep quality, as insufficient rest can disrupt hormone levels that influence bone metabolism, including growth hormone and cortisol. Stress management techniques such as meditation or breathing exercises can also play an indirect role in supporting bone health by reducing systemic inflammation. These practices form a foundation of proactive care, turning everyday routines into opportunities to protect and even enhance skeletal strength over time.
A DEXA scan for bone health essentially tells the doctor whether to “watch and wait” or to start therapy. If the DEXA shows only mild osteopenia, doctors often emphasize lifestyle measures and monitoring bone loss over time. If the scan shows osteoporosis, you typically start medication right away; if the scan indicates only osteopenia, the focus is on preventive measures and scheduling the next scan in a few years.
Follow-Up and Long-Term Monitoring
For those with normal or near-normal results, follow-up can be spaced out. In fact, experts note that routine bone monitoring can often be less frequent if risk remains low. For healthy postmenopausal women without osteoporosis, repeated BMD testing after 3 years does not enhance fracture risk prediction. In practical terms, this means if your first DEXA at 65 was normal, you might not need another scan until age 70 (or later) unless circumstances change. Physicians will reassess your risk over time. If you remain healthy with no new risk factors, the interval between scans can be extended. However, if you develop new issues, they may shorten the interval. Another part of these follow-up guidelines suggests that women ages 50–64 with relatively high T-scores could defer retesting until age 65, when routine screening begins for all women. Routine bone monitoring strikes a balance between risk and benefit. Patients with normal scans and few risk factors can wait multiple years, while those with any worrisome changes should scan again sooner. These follow-up plans ensure you’re not tested unnecessarily often, but also not overlooked if bone health starts to decline.
DEXA for Body Composition and Other Uses
Although most people associate DEXA with bone checks, the same scan can also measure body fat and muscle. A body DEXA scan involves doing a whole-body scan instead of focusing only on the hip/spine. DEXA is an accurate body composition test that can distinguish between fat mass, lean mass, and bone. Many fitness centers and research programs now offer DEXA to athletes and dieters for this reason. After a total-body scan, you get percentages of body fat, lean tissue, and bone. This can help guide nutrition or training plans. A personal trainer might use DEXA results to adjust an exercise program to build muscle or lose fat. A body composition test with DEXA gives more precise data than body mass index (BMI) or calipers.
Finding and Scheduling a DEXA Scan
Anyone needing a bone density test will look for an accredited clinic for DEXA scan services. Many radiology centers, hospitals, and specialized imaging clinics provide DEXA. Patients typically get a physician referral, though some outpatient facilities allow direct scheduling. To book DEXA scans, you can often do so online. Major health systems also list imaging schedules on their patient portals. There are even mobile bone densitometry units in some areas.
When preparing for a DEXA scan, several practical considerations can help ensure the results are as accurate and meaningful as possible. Physicians generally recommend avoiding calcium supplements for the 24 hours leading up to the appointment, as elevated levels of calcium in the bloodstream may subtly interfere with the machine’s ability to measure bone density with precision. This precaution does not mean calcium is harmful, but rather that recent supplementation can temporarily alter absorption patterns, creating a reading that does not reflect your long-term baseline. Along with this dietary step, it is important to wear clothing that is loose-fitting and free from zippers, snaps, or other metal details. Metal components can distort the imaging process, forcing technicians to make adjustments or requiring you to change into a medical gown, which can unnecessarily prolong the appointment. Additionally, patients are advised to avoid heavy meals in the hours leading up to the scan, as fullness or bloating can sometimes make lying flat uncomfortable. Proper hydration is encouraged, but arriving in a natural state of balance, neither dehydrated nor overhydrated, supports consistent and reliable readings. Unlike more invasive diagnostic procedures, there is no need for fasting, injections, or special preparation, which makes DEXA highly convenient for patients balancing busy schedules. Establishing a calm mindset before the test is also valuable, because the exam requires you to remain very still; taking a few moments beforehand to relax can reduce fidgeting or subtle movements that might otherwise compromise image clarity. These preparatory measures, though simple, lay the foundation for a scan that accurately reflects your bone density and body composition, allowing your healthcare provider to make fully informed recommendations.
The scan itself is designed to be efficient and stress-free, typically lasting only 10 to 20 minutes for a standard evaluation of the hip and spine. After removing any remaining jewelry or accessories, you will be guided to lie on a padded table while the scanning arm glides gently over your body. Unlike MRI or CT scans, which enclose the body and can trigger claustrophobic feelings, the DEXA machine is open and quiet, minimizing discomfort or anxiety. A low-dose X-ray beam passes through the body, and sensors detect the amount of energy absorbed by bone compared to surrounding tissues. This differential absorption provides precise data about bone mineral content and, in many facilities, body composition such as lean mass and fat distribution. During the exam, you may have supports placed under your knees to flatten the lower spine or a brace around the foot to position the hip, but these measures are painless and designed solely for alignment. Patients are encouraged to breathe normally, though they may be asked to hold still for short intervals while images are captured to prevent motion blur. Once the scan is complete, the machine’s software immediately begins processing the results, producing a report that quantifies bone density using standardized scores widely used for osteoporosis assessment. Because radiation exposure is minimal, comparable to what you might receive during a short airplane flight, there is no recovery period, and you can resume your daily activities immediately.
In the US, you have a choice of DEXA scan providers. Many orthopedic or women’s health clinics also offer scans. The price may be covered by insurance if it’s for a Medicare-eligible individual or a physician’s order. Afterward, you wait a few days to receive your official results from your doctor.
Bone density testing is an essential part of preventive health for older adults and others at risk. By understanding your personal risk factors, scheduling a bone health check at the right time, and monitoring changes with repeat scans, you can take proactive steps to prevent bone loss. Working with your doctor, you’ll interpret any low scores and plan treatments or lifestyle changes as needed. For added peace of mind, remember that the same scanning technology can double as a body composition test for overall health. When it’s time for testing, you can book DEXA scans at BOD. Maintaining strong bones is a long-term project: routine testing, monitoring bone health, and timely interventions make a significant difference in fracture prevention and overall quality of life.
Sources:
- Bone Health and Osteoporosis Foundation – Clinician’s Guide to Prevention and Treatment of Osteoporosis bonehealthandosteoporosis.org
- U.S. Preventive Services Task Force – Osteoporosis to Prevent Fractures: Screening (Recommendation Summary) uspreventiveservicestaskforce.org
- AACE/American Association of Clinical Endocrinologists Osteoporosis Guidelines (as summarized by ANMC) anmc.org
- StatPearls – Dual-Energy X-Ray Absorptiometry (DEXA) overview ncbi.nlm.nih.gov
- LabFinder – Bone Density (DEXA) Test FAQs labfinder.com