Osteoporosis: Should I have a dual X-ray absorptiometry (DEXA) test?

Get the facts
Compare your options
What matters most to you?
Where are you leaning now?
What else do you need to make your decision?

1. Get the Facts

Your options

Have the DEXA test to find out whether you need treatment for osteoporosis.
Don't have the test.

Key points to remember

It's important to know if you are at risk for osteoporosis. The DEXA test measures bone thickness to find out if you have osteoporosis or if you are at risk for a broken bone (fracture). You can also assess your risk by checking your risk factors. Try this Interactive Tool: Are You at Risk for Osteoporosis?
The United States Preventive Services Task Force recommends that people 65 or older have regular tests to measure their bone thickness. The task force suggests starting testing at age 60 for people who are at risk for broken bones (fractures) caused by osteoporosis.¹
You probably don't need this test if:
- You are at low risk for osteoporosis and are younger than 65.
- You have osteoporosis but are not willing to make lifestyle changes or take medicines to treat it.
The test may be a good choice for you if you are at risk for osteoporosis and are willing to make lifestyle changes and take medicines to treat it.

FAQs

What is osteoporosis?

Osteoporosis is a disease that affects your bones. It means that your bones are thin and brittle, with lots of holes inside them like a sponge. This makes them easy to break. Osteoporosis can lead to broken bones (fractures) in the hip, spine, wrist, and other parts of your body. These fractures can be disabling and may make it hard for you to live on your own.

See a picture of healthy bone versus bone weakened by osteoporosis .

What is the DEXA test?

The DEXA is an X-ray test that measures bone thickness. It is used to see if your bones are getting thin and brittle, which means they could break more easily.

The results of the test may show that you need treatment for osteoporosis.

What can increase your risk for osteoporosis?

A risk factor is anything that can increase your risk of getting a disease. Some risk factors you can change so that you reduce your risk. Others you can't change.

Risk factors you can't change include:

Your age. Your risk for osteoporosis goes up as you get older.
Being a woman who has gone through menopause. After menopause, your body makes less estrogen. Estrogen protects the body from bone loss.
Your family history. Osteoporosis tends to run in families.
Having a slender body frame.
Your race. People of European and Asian background are most likely to get osteoporosis.
Your health. You may be at higher risk if you have a medical problem such as hyperthyroidism that makes it hard for your body to absorb enough calcium.
Having surgery to remove your ovaries before menopause.

Risk factors you can change include:

Smoking.
Not getting enough weight-bearing exercise, such as running, walking, or lifting weights.
Drinking large amounts of alcohol.
Not getting enough calcium and vitamin D.
Using steroid medicines for 6 months or longer. But you may not be able to stop taking these, depending on why you are taking them.

To check your risk, try this Interactive Tool: Are Your at Risk for Osteoporosis?

Who should get a bone density test?

The United States Preventive Services Task Force recommends that people 65 or older have regular tests to measure their bone thickness. The task force suggests starting testing at age 60 for people who are at risk for broken bones (fractures) caused by osteoporosis.¹

Here are some other things to think about:

If you are younger than 65 and don't have any risk factors for osteoporosis, you may not need this test.
If you are younger than 60 and have one or more risk factors for osteoporosis, you may want to think about having the test. You may be able to lower your risk for broken bones and other problems caused by osteoporosis with treatment and lifestyle changes.
You may also want to have this test if you have a low-trauma fracture. Low trauma means that you broke a bone doing something that would not normally cause a broken bone, such as a simple fall.
If you have osteoporosis and are being treated, you may want to have follow-up bone mineral density tests to see how well your treatment is working. These tests are usually done every 2 years.² Getting follow-up tests doesn't make your treatment work better.³

What can you expect if you get a bone density test?

If you have risk factors for osteoporosis and choose to get the test, the results can help you make decisions about treatment. Treatment can help strengthen bones and prevent fractures.

What can you expect if you do NOT get a bone density test?

If you are younger than 65 and don't have any risk factorsfor osteoporosis, this test won't be very useful. You may want to have the test when you reach age 65. But in the meantime, if you are worried about getting osteoporosis, talk with your doctor about lifestyle changes you can make to keep your bones strong.

If you are at risk for osteoporosis and have a healthy lifestyle but are not willing to take medicines for treatment, the test may not be helpful. The results of the test would not change what you are already doing to keep your bones strong.

Why might your doctor recommend a DEXA test?

Your doctor may advise you to get this test if:

You are 65 or older and have other risk factors for osteoporosis.
You are willing to make changes to your lifestyle or take medicines if the test shows that you have osteoporosis.

2. Compare Options

	Have the DEXA test	Don't have the test
What is usually involved?	The DEXA test is done in a radiology department or clinic. It takes about 20 minutes. X-rays are taken of the hip and spine to measure bone thickness.	You may check your risk factors. See the Interactive Tool: Are You at Risk for Osteoporosis? If you are worried about osteoporosis, you can adopt healthy habits such as quitting smoking and getting more weight-bearing exercise.
What are the benefits?	The test measures bone thickness. It can help show if you are at risk for having broken bones (fractures) because of osteoporosis, and it can help guide decisions about treatment.	You avoid the costs of the test.
What are the risks and side effects?	During the X-ray test, you are exposed to a very low dose of radiation. The test is not recommended for pregnant women because of radiation exposure to the unborn baby.	You may be at risk for broken bones from osteoporosis and not know it.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topics:

Personal stories about deciding whether to have a bone density test

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" I am uncertain about taking medications for osteoporosis. I have a few risk factors for osteoporosis, but not many. I think that knowing my bone density would give me at least one objective piece of information I can use to make the medication decision."

— Janet, age 52

" I have a number of risk factors for osteoporosis, and I have watched my mother's struggle with spinal fractures over the past few years. In her day, they didn't know as much about using hormones after menopause to prevent "brittle bones." I already take calcium and vitamin D and have already decided that I will take osteoporosis medication, so my doctor and I agree that for now there is no real reason for me to have a bone density test."

— Annamaria, age 51

" I slipped on the ice last week and broke my wrist. It didn't seem like a very serious fall, and the doctor said that because of my age, she wondered if perhaps I might have osteoporosis. I had decided not to take hormones when I went through menopause, and I probably haven't been getting quite as much calcium as I should. I am going to have the bone density test and see if maybe I have osteoporosis. I hear there are some medications that can help treat it. And either way, I will definitely start taking my calcium supplements."

— Elsie, age 71

" I was surprised to find that I don't have any risk factors for osteoporosis other than getting older. And I've always enjoyed drinking milk, so I don't have a problem getting enough calcium. I exercise, and I don't smoke or drink. Really, I think my bones are healthy! I'm not taking hormones after menopause, and I feel like I am at such low risk of getting osteoporosis that the bone density test isn't necessary for me at this point. I'm going to talk it over with my doctor."

— Sharon, age 55

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have a DEXA test

Reasons not to have a DEXA test

I think I'm at risk for osteoporosis, and I want to know for sure.

I don't think I'm at risk for osteoporosis.

More important

Equally important

More important

I'm willing to make lifestyle changes and take medicines if I am at risk.

I'm not willing to make any changes or take medicines.

More important

Equally important

More important

The cost of the test doesn't bother me.

I'm worried about the cost of the test.

More important

Equally important

More important

My other important reasons:

More important

Equally important

More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having the test

NOT having the test

Leaning toward

Undecided

Leaning toward

5. Quiz Yourself

Check the facts.

1. Is getting the bone density test a good choice for everyone?

Yes
No
I'm not sure

You're right. You probably don't need this test if you are at low risk for osteoporosis and are younger than 65.

2. Is it important to know your risk for osteoporosis?

Yes
No
I'm not sure

You're right. It is important to know your risk for osteoporosis. But you can find out without getting a bone density test.

3. Is the test recommended for anyone age 65 or older?

Yes
No
I'm not sure

You're right. The U.S. Preventive Services Task Force recommends routine bone mineral testing if you are 65 or older.

Decide what's next.

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty.

1. How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2. Check what you need to do before you make this decision.

Nothing. I'm ready to take action.
I want to discuss the options with others.
I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

References

Citations

U.S. Preventive Services Task Force (2002). Screening for osteoporosis in postmenopausal women: Recommendations and rationale. Annals of Internal Medicine, 137(6): 526–528.
National Osteoporosis Foundation (2008). Clinician's Guide to Prevention and Treatment of Osteoporosis. Available online: http://www.nof.org/professionals/Clinicians_Guide.htm.
Nelson HD, et al. (2001). Osteoporosis in Postmenopausal Women: Diagnosis and Monitoring. Evidence Report/Technology Assessment No. 28 (AHRQ Publication No. 01-E032). Rockville, MD: Agency for Healthcare Research and Quality.