The Women's Health Resource. On the web since 1997.

Researchers Determine Which Women Should Receive Bone Density Screening Exams

In a study of over 1600 women, researchers have identified three risk factors that contribute to high risk of osteoporosis : age, weight, and estrogen use. Older, thin women who have never take estrogen (in the form of oral contraceptives or hormone replacement therapy ) are at an increased risk for osteoporosis, compared to women who do not have these risk factors. Based on the study, the researchers are recommending that women with any one of these risk factors be screened for osteoporosis with bone mineral density tests.

In the study, Louis Weinstein, MD and Brain Ullery, MD from the Medical College of Ohio in Toledo, had 1610 women complete a questionnaire to evaluate their risk of osteoporosis. After completing the questionnaire, each woman underwent a DEXA (Dual Energy X-ray Absorptiometry)

scan to determine her bone mineral density. According to the results of the study, women over age 65 who weighed less than 140 pounds at menopause and had never used estrogen for more than six months were at the highest risk of osteoporosis.

The researchers found that these risk factors—older age, lower body weight, and lack of estrogen use—contributed to osteoporosis of the spine, hip, and femoral neck in the women who participated in the study. Of the 1610 women who underwent DEXA scans, 64.7% did not have osteoporosis, 35.3% had osteoporosis at one or more sites, and 10.4% had osteoporosis at all three of these sites.

Based on their research, Dr. Weinstein and his colleagues have created a mnemonic ABONE to help women and their physicians determine who is at high risk for osteoporosis. In ABONE, A stands for age, B stands for bulk, and ONE stands for never estrogens. According to the researchers, if a patient has one or more of these risk factors, she should be screened for osteoporosis.


A = age (older women are at higher risk of osteoporosis)

B = bulk (women with lower body weight are at higher risk of osteoporosis)

ONE = never estrogens (women who have not used estrogen are at higher risk of osteoporosis)

In addition to the risk factors identified by Dr. Weinstein and his colleagues, additional risk factors for osteoporosis include:

  • Female gender
  • Family history of osteoporosis
  • Race (Asian and Caucasian women are at greater risk for osteoporosis)
  • Smoking and alcohol use
  • Never having children
  • History of broken bones
  • Certain diseases (such as anorexia (an eating disorder), celiac disease (an inability to tolerate grain products), diabetes, chronic diarrhea, or kidney or liver diseases)
  • Lack of exercise
  • Low calcium intake as a child or adult
  • Certain medications and steroids (such as steroids to treat asthma and arthritis (such as cortisone and prednisone), high doses of thyroid hormone, medications used to treat seizures (such as phenobarbital and phenytoin (trade name Dilantin))
  • Osteoporosis is a degenerative bone disease that affects roughly 25 million Americans. Osteoporosis occurs from a decrease in normal bone density due to the loss of calcium and collagen. A loss of bone density causes bones to become brittle, and in turn, leads to frequent fractures and other serious effects. It is estimated that one third of post-menopausal women have osteoporosis.

Additional Resources and References