Am I losing bone without knowing it?
Bone loss has no symptoms until a bone breaks, and it speeds up for women around menopause. Who is most at risk, what a DEXA bone density scan is like, and what your T-score means.
- Women's health
- Bone health
- Menopause
Medically reviewed by Dr. William Aung, DocDocDash’s partner doctor network.
Last reviewed: October 2026.
The short answer: You could be, and you wouldn’t feel it. Bone loss has no symptoms until a bone breaks, and it speeds up for women around menopause. The only way to know where your bones stand is a DEXA bone density scan, a quick, painless X-ray scan of your hip and spine that takes about 15 minutes.
Most women only think about their bones after a fall or a fracture. By then, years of silent bone loss may already have happened. This guide explains why bone loss is so easy to miss, who is most at risk, and how a DEXA scan gives you a clear answer while there is still plenty of time to act.
DEXA bone density scan: the quick test that shows how strong your bones are
What is it? A low-dose X-ray scan that measures how dense, and therefore how strong, the bones in your hip and lower spine are.
Who should get one? Women 65 and over, and younger women after menopause who have risk factors such as early menopause, low body weight, a family history of hip fracture, or long-term steroid use.
Does it hurt? No. You lie still on a padded table while the scanner arm passes over you. There are no needles and no tunnel.
How long does it take? About 10 to 20 minutes.
What does the result tell me? Whether your bones are normal, have low bone mass (osteopenia), or have osteoporosis, and how likely you are to break a bone in the next 10 years.
What if my bones are thinning? Exercise, calcium, vitamin D and, when needed, medicine can slow bone loss and lower your fracture risk.
Why can I lose bone without any symptoms?
Bone is living tissue. Your body constantly breaks down old bone and builds new bone. Until about age 30, building wins, and you reach your “peak bone mass”. After that, you slowly lose a little more than you make.
When the loss goes too far, bones become thin and fragile. This is called osteoporosis, which means “porous bone”. The earlier stage, when bone is lower than normal but not yet osteoporosis, is called osteopenia.
Thin bones don’t ache or feel different, which is why osteoporosis is often called a “silent disease”. The first sign is often a broken wrist, hip or spine bone after a minor fall, or even a cough or a bend. Around 1 in 3 women over 50 will have a fracture caused by osteoporosis.
Late clues worth noticing:
- Losing height (more than about 3 to 4 cm)
- A more stooped or rounded upper back
- Sudden back pain without a clear injury, which can be a small fracture in the spine
- Breaking a bone from a fall that wouldn’t normally cause one
If you’re already noticing these, a bone check is overdue. You can also read about “Why do my bones ache and I feel tired all the time?”.
Why are women at higher risk, especially after menopause?
Estrogen helps protect bone. When estrogen falls during perimenopause and menopause, bone loss speeds up sharply, especially in the first 5 to 7 years after your last period. Women also start with smaller, lighter bones than men, so there is less “bone in the bank” to lose.
Am I at higher risk? Your risk is higher if any of these apply:
- You are past menopause, or your menopause came early (before 45)
- You have a small, slim frame or low body weight
- A parent broke a hip
- You have taken steroid tablets (such as prednisolone) for 3 months or more
- You have rheumatoid arthritis, an overactive thyroid, or a condition that affects how you absorb food
- You smoke, or drink more than 2 to 3 alcoholic drinks a day
- You get little calcium, little sunlight or little exercise
Why Asian women should pay attention: many Asian women have a smaller body frame, lower calcium intake from a diet low in dairy, and low vitamin D levels, especially those living and working indoors in cities. Rates of hip fracture across Asia are rising as populations live longer.
What is a DEXA bone density scan and what is it like?
DEXA (sometimes written DXA) stands for dual-energy X-ray absorptiometry. In plain words, it uses two very low-dose X-ray beams to measure how much mineral is packed into your bones. It is the standard test doctors use worldwide to diagnose osteoporosis.
What happens during the scan:
- You lie on your back on a padded table, usually in your own clothes if they have no metal.
- A scanner arm passes slowly over your lower spine and one or both hips. Some clinics also scan the forearm.
- You stay still and breathe normally. There is no tunnel, no noise and no needles.
- The scan takes about 10 to 20 minutes, and you can go straight back to your day.
Is radiation safe? Yes. A DEXA scan uses a very small dose of radiation, lower than a standard chest X-ray.
What do my DEXA results mean?
Your report will show a T-score, which compares your bone density with that of a healthy young adult. The lower the number, the thinner the bone.
| T-score | What it means | Usual next step |
|---|---|---|
| -1.0 or higher | Normal bone density | Keep up healthy habits; recheck as advised |
| Between -1.0 and -2.5 | Low bone mass (osteopenia) | Lifestyle changes; doctor checks your fracture risk; repeat scan in 1 to 3 years |
| -2.5 or lower | Osteoporosis | Discuss treatment with your doctor |
What is a Z-score? It compares your bones with women of your own age. Doctors use it mostly for women who haven’t reached menopause yet. A low Z-score can point to another cause of bone loss worth checking.
Fracture risk (FRAX): many doctors combine your DEXA result with your age and risk factors to estimate your chance of a major fracture in the next 10 years. This helps decide whether you need medicine, not just lifestyle changes.
When should I get a bone density scan?
Guidelines differ slightly between countries, but this is a common approach. Your doctor will tailor it to you.
| Your situation | When to consider a DEXA scan |
|---|---|
| Woman aged 65 or over | Recommended for all women |
| After menopause, under 65, with one or more risk factors | Now, as a baseline |
| Early menopause (before 45) | Around the time of menopause |
| Long-term steroid tablets, or a condition that affects bones | Ask your doctor now, at any age |
| Broke a bone after age 50 from a minor fall | As soon as possible |
| Considering or taking HRT or bone medicine | Before starting, then as advised to track progress |
Already had a scan? If your result was normal, many doctors suggest rechecking in a few years. With osteopenia or on treatment, a repeat scan is often done every 1 to 2 years.
What can I do if my bones are getting thinner?
The good news: bone loss can be slowed, and fracture risk can be lowered at any age.
Everyday habits that protect bone:
- Strength training and weight-bearing exercise, such as brisk walking, stair climbing, dancing or lifting weights, a few times a week
- Enough calcium, from foods like tofu set with calcium, small fish with soft bones, leafy greens, fortified soy milk or dairy
- Enough vitamin D, from safe sunlight and, if your level is low, a supplement your doctor recommends
- Enough protein, spread across your meals, to support bone and muscle
- Stopping smoking and limiting alcohol
- Preventing falls, with good lighting at home, sturdy shoes, and balance exercises such as tai chi
Medical treatment: if you have osteoporosis or a high fracture risk, your doctor may suggest medicine that slows bone loss or helps build new bone. For some women around menopause, hormone replacement therapy (HRT) is also an option. Your doctor will explain the benefits and side effects of each.
Your doctor may also check vitamin D, calcium, thyroid and kidney function with a simple blood test, to look for other causes of bone loss.
How do I prepare for a DEXA scan?
- Skip calcium supplements for 24 hours before the scan. They can affect the reading.
- Wear comfortable clothes without metal, such as zips, buttons, belts or underwire.
- Tell the clinic if you’ve had a barium test or a scan with contrast dye in the past 1 to 2 weeks, or if you might be pregnant.
- Bring any previous DEXA reports. Comparing results on the same machine type gives the clearest picture of change.
- Note your risk factors, such as your age at menopause, past fractures, family history and long-term medicines.
Frequently asked questions
Can a normal X-ray show if I have osteoporosis? Not reliably. Bone usually has to lose a large amount of mineral before it looks thin on a regular X-ray. A DEXA scan picks up changes much earlier.
Can osteopenia turn into osteoporosis? It can, but it doesn’t have to. Exercise, calcium, vitamin D and stopping smoking can slow bone loss, and regular scans track how you’re doing.
Do men need bone density scans too? Yes, especially men over 60 or men with risk factors. Bone loss happens later in men, but it does happen.
Can I get a DEXA scan abroad? Yes. DEXA scans are widely available in hospital check-up centres and can often be done on the same day as a wider health screening. DocDocDash can help you compare and book.
Know where your bones stand with DocDocDash. We help you book a DEXA bone density scan, on its own or as part of a women’s health or menopause check-up, at trusted and JCI accredited hospitals. You’ll see clear prices up front, and a doctor will explain your results and next steps.
Sources:
- International Osteoporosis Foundation (IOF): osteoporosis facts and statistics, including the 1 in 3 women over 50 figure
- Bone Health & Osteoporosis Foundation (BHOF): bone density testing
- US Preventive Services Task Force (USPSTF): osteoporosis to prevent fractures, screening recommendation
- NHS: Osteoporosis
- Asian Federation of Osteoporosis Societies (AFOS): osteoporosis guidance for Asia
- FRAX fracture risk assessment tool (University of Sheffield)