Skip to content
How It Works
Explore
Ask a Question Resources Pricing
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Sign Up
PubMed This is a summary of 18 peer-reviewed journal articles Updated

When Should Women and Men Get a DXA Scan for Osteoporosis?

At a Glance

Routine DXA screening generally begins at 65 for women. The Bone Health and Osteoporosis Foundation recommends screening men at 70, while the USPSTF finds evidence insufficient for universal screening in men. Earlier testing may be needed after a fragility fracture, early menopause, POI, or prolonged steroid use.

In this answer

4 sections

01

Standard Screening Guidelines

02

When Should You Get Screened Earlier?

03

Why Guidelines Differ for Men and Women

04

What to Expect and Next Steps

For most adults without specific risk factors, routine bone density screening with a DXA scan (dual-energy x-ray absorptiometry) is recommended starting at age 65 for women and age 70 for men [1][2]. However, if you have certain risk factors—such as early menopause, a history of fractures from minor falls, or use of medications like steroids—your doctor may recommend getting a scan and completing a formal risk assessment much earlier [3].

Standard Screening Guidelines

Medical organizations have established clear U.S. guidelines for routine osteoporosis screening. A DXA scan is a low-dose x-ray that measures your bone mineral density (usually at the hip and lumbar spine), helping to estimate your risk of breaking a bone [4][5].

  • Women age 65 and older: The US Preventive Services Task Force (USPSTF) and the Bone Health and Osteoporosis Foundation (BHOF) recommend routine screening for all women starting at age 65 [1][2].
  • Men age 70 and older: The BHOF recommends routine DXA scans for all men starting at age 70 [2]. However, the USPSTF states there is currently insufficient evidence to make a recommendation for or against universal screening in men [1].
  • Postmenopausal women under 65: Screening is not routinely recommended for all younger postmenopausal women unless a formal fracture-risk assessment shows an increased risk [6]. Younger, premenopausal adults generally do not need routine screening, and their results are interpreted differently (using Z-scores that compare them to their peers, rather than the T-scores used to diagnose osteoporosis in older adults) [7].

When Should You Get Screened Earlier?

Your doctor may recommend earlier evaluation if you have factors that accelerate bone loss. Often, clinicians use a risk calculator like FRAX to estimate your fracture risk and decide if a DXA scan is appropriate [8]. Important FRAX risk factors include a parent who has had a hip fracture, low body weight, rheumatoid arthritis, smoking, and high alcohol intake [9].

You should discuss getting a DXA scan before the standard recommended ages if you experience:

  • A low-trauma fracture: Breaking a bone from a minor fall from standing height or less (a fragility fracture), especially in the wrist, forearm, hip, or spine [10]. Note that some hip and spine fractures require prompt treatment evaluation regardless of what a DXA scan shows [11].
  • Early menopause or POI: Menopause occurring between ages 40 and 44 (early menopause) or the loss of normal ovarian function before age 40 (premature ovarian insufficiency, or POI) reduces estrogen levels, leading to rapid bone loss [12][13][14]. A DXA scan is often recommended at the time of diagnosis for POI [15].
  • Systemic steroid use: Taking systemic glucocorticoids (such as prednisone) at a dose of 2.5 mg or more per day for more than 3 months is a strong trigger for prompt fracture-risk assessment, including a DXA scan [16].

Why Guidelines Differ for Men and Women

Osteoporosis affects men too, but guidelines recommend routine screening for men later than for women because men generally start with more bone mass and lose it at a slower rate [2]. In contrast, women experience a rapid decline in bone density during the menopausal transition due to a sharp drop in bone-protecting estrogen [14].

What to Expect and Next Steps

The DXA scan itself measures bone mineral density, but density alone does not equal your total fracture risk [5]. A normal or mildly low result does not mean your risk of breaking a bone is zero.

If your first scan is normal, there is no single rule for when to repeat it. The timing depends on your age, initial results, new medications, and whether you are starting treatment. While some medical groups advise against repeating a scan within 2 years of the first one, shorter intervals may be needed if you take steroids, begin osteoporosis medication, or have a baseline T-score showing osteoporosis [17][18].

Common questions in this guide

When should a woman have her first DXA scan?
For women without specific risk factors, U.S. guidance recommends routine DXA screening starting at age 65. A postmenopausal woman younger than 65 may still need testing if a fracture-risk assessment shows elevated risk.
When should a man start bone density screening?
The Bone Health and Osteoporosis Foundation recommends routine DXA screening for men beginning at age 70. The USPSTF says evidence is currently insufficient to recommend for or against universal screening in men, so personal risk factors and clinician judgment matter.
What can make me eligible for a DXA scan before the usual age?
Earlier testing may be appropriate after a fracture from a minor fall, early menopause, premature ovarian insufficiency, or systemic steroid use such as prednisone at 2.5 mg daily or more for over three months. Other factors considered in a fracture-risk assessment include a parent with a hip fracture, low body weight, rheumatoid arthritis, smoking, and high alcohol intake.
What does a DXA scan tell me about osteoporosis?
A DXA scan is a low-dose X-ray that measures bone mineral density, usually at the hip and lower spine. The result helps estimate fracture risk, but bone density alone does not capture every factor, so a normal or mildly low result does not make fracture risk zero.
How soon should a normal DXA scan be repeated?
There is no single repeat schedule because timing depends on your age, first result, new medicines, and whether you start osteoporosis treatment. Many medical groups advise against repeating the scan within two years, although shorter intervals may be considered with steroid use, osteoporosis treatment, or a baseline result showing osteoporosis.
Does a hip or spine fracture matter even if my DXA result is normal?
Yes. Some hip and spine fractures require prompt treatment evaluation regardless of the DXA result. Your clinician will consider how the fracture happened and your overall fracture risk when deciding next steps.

Questions For You

Answer a question to get research tailored to you. Your answers are private.

Related questions

What Is the Prolia Rebound Effect After Stopping Treatment? When Should You Get a DXA Scan After Osteoporosis Treatment? Which Exercises Should You Avoid With Osteoporosis? Can Spinal Arthritis Falsely Raise Your DXA T-Score? Can Diet and Exercise Reverse Osteoporosis Without Meds?
Show more
What Is High-Risk vs. Very High-Risk Osteoporosis? How to Cope With Fear of Falling After Osteoporosis When and How Long Is a Bisphosphonate Drug Holiday? Why Follow Osteoporosis Bone Builders with Antiresorptives? How Do Steroids Like Prednisone Cause Osteoporosis? How Do Diabetes and Steroids Affect DXA and FRAX Accuracy? What Is the Risk of MRONJ and Atypical Femur Fractures? Can Men Get Osteoporosis? Risk Factors and Screening

Get notified when new evidence is published on osteoporosis.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Based on my medical history and menopause timing, do I have enough risk factors to warrant a FRAX risk assessment before age 65?
  2. 2.Since I take a medication like prednisone, exactly what dose and duration makes me eligible for a bone density scan?
  3. 3.If I have a fragility fracture, should I start treatment regardless of my DXA T-score?
  4. 4.If my first DXA scan results are normal, when should we schedule the next one?

References

References (18)
  1. 1

    Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement.

    , Curry SJ, Krist AH, et al.

    JAMA 2018; (319(24)):2521-2531 doi:10.1001/jama.2018.7498.

    PMID: 29946735
  2. 2

    ACR Appropriateness Criteria® Osteoporosis and Bone Mineral Density: 2022 Update.

    , Yu JS, Krishna NG, et al.

    Journal of the American College of Radiology : JACR 2022; (19(11S)):S417-S432 doi:10.1016/j.jacr.2022.09.007.

    PMID: 36436967
  3. 3

    Bone Density Screening and Re-screening in Postmenopausal Women and Older Men.

    Gourlay ML, Overman RA, Ensrud KE

    Current osteoporosis reports 2015; (13(6)):390-8 doi:10.1007/s11914-015-0289-5.

    PMID: 26408154
  4. 4

    To scan or not to scan? DXA in postmenopausal women.

    DeSapri KT, Brook R

    Cleveland Clinic journal of medicine 2020; (87(4)):205-210 doi:10.3949/ccjm.87a.18136.

    PMID: 32238375
  5. 5

    [Diagnosis of osteoporosis-importance of dual-energy X-ray absorptiometry].

    Genest F, Seefried L

    Orthopadie (Heidelberg, Germany) 2026; (55(9)):755-764 doi:10.1007/s00132-026-04878-x.

    PMID: 42554754
  6. 6

    Diagnosis and Management of Osteoporosis.

    Jeremiah MP, Unwin BK, Greenawald MH, Casiano VE

    American family physician 2015; (92(4)):261-8.

    PMID: 26280231
  7. 7

    Use of dual-energy X-ray absorptiometry (DXA) for diagnosis and fracture risk assessment; WHO-criteria, T- and Z-score, and reference databases.

    Dimai HP

    Bone 2017; (104()):39-43 doi:10.1016/j.bone.2016.12.016.

    PMID: 28041872
  8. 8

    Comparison of the Osteoporosis Self-Assessment Tool for Asians and the fracture risk assessment tool - FRAX to identify densitometric defined osteoporosis: A discriminatory value analysis in a multi-ethnic female population in Southeast Asia.

    Chandran M, Chin YA, Choo KS, et al.

    Osteoporosis and sarcopenia 2020; (6(2)):53-58 doi:10.1016/j.afos.2020.04.001.

    PMID: 32715094
  9. 9

    Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV.

    Womack JA, Murphy TE, Leo-Summers L, et al.

    AIDS (London, England) 2023; (37(9)):1399-1407 doi:10.1097/QAD.0000000000003566.

    PMID: 37070536
  10. 10

    Rate of Bone Mineral Density Testing and Subsequent Fracture-Free Interval After Distal Forearm Fracture in the Medicare Population.

    Parikh K, Reinhardt D, Templeton K, et al.

    The Journal of hand surgery 2021; (46(4)):267-277 doi:10.1016/j.jhsa.2020.11.020.

    PMID: 33495040
  11. 11

    Osteoporosis: The Renascent Impact of Vertebral Fractures-A Narrative Review of Diagnosis, Risk Stratification, and Integrated Management.

    Chi MC, Shih KS, Chen IH

    Journal of clinical medicine 2026; (15(13)) doi:10.3390/jcm15135033.

    PMID: 42452496
  12. 12

    Optimising health after early menopause.

    Mishra GD, Davies MC, Hillman S, et al.

    Lancet (London, England) 2024; (403(10430)):958-968 doi:10.1016/S0140-6736(23)02800-3.

    PMID: 38458215
  13. 13

    HRT for women with premature ovarian insufficiency: a comprehensive review.

    Webber L, Anderson RA, Davies M, et al.

    Human reproduction open 2017; (2017(2)):hox007 doi:10.1093/hropen/hox007.

    PMID: 30895225
  14. 14

    Associations of Age at Menopause With Postmenopausal Bone Mineral Density and Fracture Risk in Women.

    Shieh A, Ruppert KM, Greendale GA, et al.

    The Journal of clinical endocrinology and metabolism 2022; (107(2)):e561-e569 doi:10.1210/clinem/dgab690.

    PMID: 34537850
  15. 15

    Prevalence of Impaired Bone Health in Premature Ovarian Insufficiency and Early Menopause and the Impact of Time to Diagnosis.

    Csehely S, Kun A, Orbán E, et al.

    Journal of clinical medicine 2025; (14(12)) doi:10.3390/jcm14124210.

    PMID: 40565957
  16. 16

    2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.

    Humphrey MB, Russell L, Danila MI, et al.

    Arthritis & rheumatology (Hoboken, N.J.) 2023; (75(12)):2088-2102 doi:10.1002/art.42646.

    PMID: 37845798
  17. 17

    Incidence and Predictors of Repeat Bone Mineral Densitometry: A Longitudinal Cohort Study.

    White VanGompel EC, Franks P, Robbins JA, Fenton JJ

    Journal of general internal medicine 2017; (32(10)):1090-1096 doi:10.1007/s11606-017-4094-y.

    PMID: 28634907
  18. 18

    Intervals between bone mineral density testing with dual-energy X-ray absorptiometry scans in clinical practice.

    Lyu H, Yoshida K, Tedeschi SK, et al.

    Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 2019; (30(4)):923-927 doi:10.1007/s00198-019-04847-5.

    PMID: 30680429

This page explains general age-based DXA screening guidance for osteoporosis for informational purposes only and does not replace medical advice. Ask your clinician when screening is appropriate for your health history.