Ever had a bone scan? Why every midlife woman should – and which to book

We never used to give our bones a second thought – we can’t see them for a start and we tend to focus on our muscles which, let’s face it, are sexier. But lately bone health has become a hot topic, especially among midlife women, as with growing understanding of menopause comes greater awareness of what happens to our bones as we age.

We hit peak bone mass in our late 20s/ early 30s, then it declines at a rate of around 1 percent a year – until perimenopause when that rate triples, as we lose bone-protecting oestrogen and thus run the risk of osteoporosis, a health condition which weakens the bones. This can spell disaster for our future health and longevity if we don’t mitigate against it: one in two women – half of us! – will endure a fracture as a result weak bones, according to Royal Osteoporosis Society figures.

Hence the rise of the preventative bone scan. Specialist mobile clinics such as Screen My Bones are popping up in gym and supermarket car parks up and down the country and as part of corporate wellbeing programmes – so you can pop in for a check during your lunchbreak. Meanwhile, Dr Vonda Wright – orthopaedic surgeon and author of Unbreakable: A Woman’s Guide To Ageing With Power, £17.99 – is doing sterling work championing women’s bone health: “Your bones are silent until they break,” she warns. “And then they scream.”

There are two types of scan to check bone density (denser means stronger). Echolight Rems, an ultrasound, is the one offered by Screen My Bones and it’s relatively new to the UK. Then there’s the one you’ve probably heard of – the Dexa scan, an X-ray. Dexa is offered by the NHS in some cases but it’s not widely available so you’ll likely need to book one privately. Both options cost around £200.

So is a bone scan worth the outlay? And which one is best? I tried them both – here’s what you need to know.

Dexa scan: the lowdown

Kerry straps in for a Dexa X-ray scan

The NHS uses the Dexa scan to assess the risk of osteoporosis and fracture. Your GP is unlikely to refer you for one, especially if you’re under 50, unless you’ve previously broken a bone or have risk factors such frequent steroid use.

It takes five minutes and you lie down on a bed while a large scanning ‘arm’ passes over your lower body several times to X-ray your spine and hip. These two areas typically exhibit bone density loss earlier than other part of the body. You’re then given a T-score number for both spine and hip – this shows how your bone density compares to the optimal peak for a 25-year-old of the same sex. I had a private Dexa at the excellent BodyView in central London, with the knowledgeable radiographer instantly preparing the report and talking me through it, including lifestyle recommendations to help improve my bone health (scroll down for more on this). The amount of radiation emited is tiny so if you decide to have a scan annually, that won’t be a problem.

Echolight Rems: the lowdown

Trying the Echolight Rems ultrasound at Screen My Bones

This is the newer tech on the block. It measures the same sites – spine and hip – but analyses bone quality and well as density, so the readings are more nuanced. It’s an ultrasound and, like the Dexa, the process is painless, simple and quick. Mine, at a Screen My Bones pop-up clinic, took about 15 minutes and was a pleasant, efficient experience.

My report arrived a few days later. You get the T-scores to show bone density and also a fragility score, drawn from an analysis of the quality of your bone, ie its structural integrity. You’re also sent a series of video clips with specialist doctor explaining how to interpret your report.

Dexa scan vs Echolight Rems – which is best?

Given that Echolight Rems provides a combination of density and quality readings, it arguably gives more comprehensive feedback on your bone health. But, as osteopath Ayshe Ibrahim point out, “Dexa remains the reference standard, used in clinical guidelines, largely because we have long-term outcome data linking Dexa results to fracture risk. Echolight Rems is promising but there’s no long-term data yet.” I have a feeling that’ll be coming though.

Whichever you choose, Ibrahim says a bone scan is a useful preventative measure: “Wider NHS access to scans for women around menopause would likely improve early awareness and prevention, rather than waiting for fractures to occur.” But, she adds: “Results need to be interpreted carefully and in context, to avoid unnecessary anxiety.”

Dr Jessica Halliley, GP and aesthetic doctor, believes a bone scan is money well spent for midlife women: “If budget allows, it’s a great way to review your current bone health and allow you to make real changes if any issues are uncovered,” she says.

For me, both scan experiences were straightforward and fast, and carried out by experienced, personable staff, while the data provided was really helpful.

I’ll now have one every 1-2 years so I can track my bone health trend – and I’ll keep an eye on my mother as she heads into her late 70s, as osteoporosis can run in families. £200 is a price I’m willing to pay – when you compare that to the cost of, say, highlights at a hair salon, it’s a no brainer. And as a free starting point, I found this ‘risk checker’ tool from the Royal Osteoporosis Society, really useful. When it comes to booking a bone scan, I suggest you simply go for the one you can find in your area.

How can you improve your bone health?

My results were a little humbling. I like to think I’m super fit and healthy at 50, but my T-scores from both scans showed (mild) osteopenia in my hip. Osteopenia is the pre-cursor to osteoporosis; mild bone density loss rather than an advanced case.

Don’t panic, says Ibrahim: “A finding of osteopenia is best understood as a risk marker, not a diagnosis of osteoporosis or an inevitable trajectory towards fracture.”

And there’s lots you can do to mitigate loss of bone density:

Strength training

I’ve lifted heavy weights for five years but wish I’d started much earlier in my 30s, as my bone density was beginning its natural decline. But better late than never, right?

Look out for Training For Your Old Lady Body: An honest, no bullsh*t guide to help women (re)frame exercise, £16.14, by PT Elizabeth Davies (@Thiswomanlifts on Instagram). Coming in March, this is a well-written, data-led explainer about exactly why Future You will thank you for all those deadlifts.

Calcium, vitamin D and other useful supplements

To optimise bone health, the NHS recommends a diet rich in calcium (found in dairy, green leafy veg, tofu, nuts) and vitamin D, found in oily fish and eggs. The NHS also urges us all to take a vitamin D supplement from October to March, as we don’t typically get enough sunlight for our bodies to make it. You can do an at-home vitamin D test to check your levels.

Maz Packham, nutritionist at online supplement retailer W-Wellness, recommends bovine collagen peptide powder Bone Balance, £29.99 for 30 servings. Its bioactive peptides have been clinically proven to be absorbed into the bone tissue and to start working within six days. Packham’s seen good results with her sixtysomething mum, who took it every day for two years and found her bone density levels stayed steady.

We also rate Feel Iceland Bone Health Therapy, £32 for a 30 day supply – see our review in Glossy Empties.

HRT

I appreciate that not everyone can/ wants to take HRT but it’s “the treatment of choice for osteoporosis prevention”, according to the British Menopause Society. A study in the Endocrine Reviews journal concluded that HRT can improve bone density by 7 percent, on average, over a two-year period. My HRT patches also help in a roundabout way: they’ve greatly lessened my joint pain – so I show up more consistently and more positively to my strength-training sessions, shifting ever heavier weights while I’m there.

Maintain a normal body weight

The stereotype of the frail, tiny older lady having a life-changing fall is sadly true. A low BMI (under 18.5) means you are more likely to develop osteoporosis. And if you lose lots of weight, you can lose bone density, especially if that weight loss is rapid – this is something to bear in mind if you’re on GLP-1 injections. The conversation around weight-loss injections tends to focus on unwanted loss of muscle mass (rather than fat), but be aware that alongside muscle, you can lose bone density too. The good news is that strength training can offset this.

screenmybones.com offer bone scans from £200; BodyView from £189. Both have facilities nationwide