`I’d rather go and know’: women’s understanding and experience of DEXA scanning for osteoporosis (PMC- www.ncbi.nlm.nih.gov)

Aging is an inevitable part of life and a beautiful part of our existence. We can age in good health and well-being and also mature in grace, beauty and wisdom.

There are however some disadvantages to aging.

Bones are an integral part of our anatomy; they serve many crucial functions such as the bone in our legs supporting our entire body when standing. They interact with our muscles to enable us to move about and they protect some of our vital organs, such as the skull around our brain.

As we age, we lose bone mass or density, especially for women after menopause. The loss in bone mass or density occurs because the bones lose calcium and minerals. There is a gel-like cushion (called a disc) between each bone. As we age, the trunk (middle of the body) becomes shorter due to decreased fluid in the discs.

Why does bone health matter?

We sat down with Adriana Villamil, our DEXA technician at Oryon. In this interview we delved into why bone health is essential as we age, how DEXA scans helps diagnose osteoporosis, and the different methods of maintaining healthy bone mass.

When is a DEXA scan used?

A DEXA scan is used to detect osteoporosis for people that may be experiencing pain, have a family history of osteoporosis or people that use different types of medications that can affect the bones. Other reasons may include people that have abused different substances, such as alcohol, smoking or steroids.

Why would you need a DEXA scan?

A DEXA scan would be good to have for those with a family background of osteoporosis. However, it could have a lot to do with lifestyle nowadays. As I said, the abuse of smoking, drinking and other really, really bad habits can result in osteoporosis. Furthermore, bones can be affected by anorexia or bulimia in young females. This is the same for very active people as well, because as they can overdo and overwork the body which can affect the bones. Certain medications can also affect the bones in many ways.

You touched on anorexia in young ladies, young women, if, for instance, a 50-year-old female suffered from anorexia when they were younger, do you think it could still be a factor that affects them?

Again, it all depends on the lifestyle, if someone has suffered from anorexia / bulimia, at a young age- it really depends on how well they have looked after themselves throughout the years. Most of them may carry on the same pathway and they will get into their 50s and the 60s suffering from the same problem. And that will certainly affect the bones.

Would you recommend that all women over 50 get a DEXA scan to check for osteoporosis?

It’s very important for women over 45 to have a DEXA scan due to the menopause. Over 45 years old is the average age for early menopause.

However, I’ve seen patients that have menopause around the 50s, as young as 35 years old or generally before 40. I would certainly recommend any women who goes through the menopause has a DEXA scan.

When are some of the instances that you would recommend a woman over 50 to get a DEXA?

In the case of a person who has gone through menopause between 45 and 55, it is still good to have a DEXA scan because it will provide an overview of how their bones are and provide a baseline bone health. Especially, as the medication they might take after menopause, such as Hormone Replacement Therapy can impact bone health.

How is a DEXA scan performed?

At Oryon we have a standard DEXA device. This device is the one most commonly used around the UK, and I believe in most of the imaging centres in Europe. With this DEXA machine, we scan both hips and the lumbar spine and this provides us with a good indication of how the bone density is.

Interpreting the results: Can you please explain what T SCORE is and how it relates to the severity of osteoporosis?

The T SCORE compares your bone mass to that of a health young adult, which helps to determine whether you are at an increased risk of osteoporosis.

The score goes from -2 to 1 and if you score -1 or above the bone health is considered normal. If you score goes between -1 to -2.5 the risk increases for becoming osteoporotic. If it’s anything over minus 2.5, this is an indication that the patient is already osteoporotic. However, I’d like to add that it is very clear for the patient to find out their result from the images that you are given after your DEXA scan.

Following their results, do they need to go see a GP?

We always advise that it’s best to review your results with a healthcare specialist or GP – this can give you further clarification on your results especially if you are lower than -1. This way you can take the relevant steps to prevent anything getting worse.

Do you have any recommendations on what women over 50 can do to maintain healthy bone density?

From my own experience, the best advice I can give is to think about what you’re doing. Have you got a good lifestyle? Are you eating well? Are you playing sports? Are you drinking the right amount of water? Are you taken things that can damage your body?

This way in five years’ time you know you’re going to have positive results. We need to be conscious of what we’re doing right now and how to avoid health issues in the future. Especially for my age group – I’m 52 years old and I want to ensure I feel well in my sixties and in my seventies. So, this is the time for me to be aware and put in the good work, which is exercise, drinking plenty of water and having a healthy diet.

Are there any types of exercise you would recommend?

My recommendation would be exercises that are high impact. Anything that makes you get down and have a really good impact on the floor but, saying that, you have to be very careful with your knees. You must be very careful with your hips as well. So, I would advise that you get the recommendation off professionals, especially if you go to the gym. You can speak with trainers that can recommend what type of exercises you can do. Sometimes we suffer from pain in our knees and most times knees and hips are the two difficult areas, which you could damage more than help.

PMC published an article showing its findings where numerous women were interviewed. The women initially had different levels of understanding of osteoporosis, despite their negative expectations, the scan was ‘an overwhelmingly positive experience’ for majority of the women. (PMC- www.ncbi.nlm.nih.gov)

Why should patient choose Oryon Imaging for their private DEXA scan?

I always say you know your body very well, if you think that your body’s going through a certain change with aches and pains, then try to find out here at Oryon Imaging.

You can either be referred to us by a healthcare professional or we also have a great option where you can self-refer to us. You just need to fill out a form and if you fit within our criteria, and then we can book you in for a DEXA scan I’d like to add that it’s very affordable as well, our scans are just £95.

I’d also like to re-iterate that one of the main reasons to have the scan is that it is preventative. If you have a family history of osteoporosis, then it’s good to have the scan to check your bone health. Also, if you know there’s anything you might have abused, like a medication, smoking or drinking – check your bone health. Finally, if you’re going through menopause very early – check your bone health.

To conclude, there’s many reasons of why someone could require a DEXA scan, fundamentally however the fundamental reason is a DEXA scan can show you your current bone health is, so you have a baseline to compare it to as you age.