Many active, athletic women in midlife believe osteoporosis is a concern reserved for sedentary older adults. However, recent discussions among health professionals raise questions about the recommended age for osteoporosis screening, currently set at 65. Women entering menopause typically experience accelerated bone density loss, yet the standard practice delays screening for over a decade after menopause begins. For active women—particularly those regularly engaging in sports or intense physical activities where physical injury is a risk—waiting until age 65 may miss a critical window of opportunity to prevent osteoporosis and reduce fracture risk.
Medical guidelines provided by the U.S. Preventive Services Task Force (USPTF) maintain that osteoporosis screening should start at 65 unless significant risk factors are present. However, these recommendations largely reflect studies conducted on sedentary populations, which do not accurately represent the risks faced by active women. Athletic women who participate in high-impact sports or rigorous physical activities inherently face higher risks of fractures. This raises concern among physicians and fitness experts, advocating for earlier assessments to mitigate long-term health consequences.
The Flaws in Current Osteoporosis Screening Guidelines
Current screening recommendations from the USPTF fail to adequately address active women’s unique risks. These guidelines overlook the fact that athletes face more frequent opportunities for injury, inherently increasing fracture risk. Because most studies focus on the general sedentary population, active women’s needs and lifestyle impacts remain unaddressed.
Understanding the Importance of Early Detection
Early detection of bone density issues is crucial. Recognizing declining bone health before osteoporosis fully develops allows women to adopt proactive measures. Lifestyle changes, tailored fitness regimens, and dietary adjustments implemented during midlife can significantly slow or even prevent severe bone density loss.
Limitations of Traditional Osteoporosis Treatments
Many active women prefer to avoid traditional osteoporosis medications like bisphosphonates due to side effects ranging from gastrointestinal issues to rare but serious complications like atypical femur fractures and osteonecrosis of the jaw. Consequently, detecting and addressing bone health issues early, before traditional treatments become necessary, is particularly valuable.
Hormone Therapy as a Preventative Strategy
Estrogen-based hormone therapy is approved by the FDA as an effective preventive strategy for preventing osteoporosis. However, hormone therapy is safest when started closer to menopause onset, typically under age 60 and within 10 years of menopause onset. If osteoporosis screening is delayed until 65, many women will miss this window for hormone therapy as an option for osteoporosis prevention.
Personalized Approaches to Protecting Bone Health
Active women benefit most from personalized approaches to bone health, taking into account medical and activity-related risk factors, age, level of fitness, and nutritional status. Understanding these factors at menopause onset provides an opportunity to use a wide range of medical, nutritional, and movement options that are individualized and can empower women to optimize their bone health, reduce fracture risk, and maintain the physical activities they enjoy safely into later life.
Delaying osteoporosis screening until age 65 may increase unnecessary risks for active, athletic women, potentially leading to preventable fractures and compromised performance. It’s vital to recognize the limitations of current guidelines and assessment tools, advocating instead for personalized, proactive approaches to bone health. Dr. Carla DiGirolamo, a pioneer in women’s performance endocrinology, understands these challenges uniquely. Specializing in helping active and high-performing women optimize their health from puberty through menopause, Dr. DiGirolamo emphasizes early and comprehensive bone health evaluations. Don’t leave your bone health to chance. Take proactive steps today to protect your active lifestyle and longevity.