STOP performing DXA scans in healthy, perimenopausal women

START counseling all women on lifestyle interventions to avoid fractures

Associate Professor, Department of Obstetrics and Gynecology, and Director, Division of Midlife Women’s Health and Primary Care, University of Cincinnati. Dr. Larkin is also Medical Director of the UC Health Women’s Center, West Chester, Ohio. She is a NAMS certified menopause practitioner.

Professor and Associate Chairman, Department of Obstetrics and Gynecology, University of Florida College of Medicine–Jacksonville. Dr. Kaunitz serves on the OBG Management Board of Editors.

The authors report no financial relationships relevant to this article.

CASE: Premature treatment for osteopenia

A 57-year-old woman presents to establish care and discuss concerns related to menopause and osteoporosis management. She is G2P2, healthy, 5 ft 6 in, and 130 lb. She underwent natural menopause at age 51; her vasomotor symptoms have been mild, and she has not used hormone therapy. Upon annual physical examination at age 52, her former physician referred her for a mammogram, bone-density assessment, and colonoscopy. Osteopenia (femoral neck T-score, –1.8) was noted on dual-energy x-ray absorptiometry (DXA), and alendronate 70 mg per week was started.