Osteoporosis screening: when should I get a bone density test?

What the guidelines say

Sources: USPSTF (USPSTF 2025), Bone Health and Osteoporosis Foundation (BHOF 2022).

The two steps for women under 65

For postmenopausal women younger than 65, the USPSTF suggests two steps (USPSTF 2025):

1. Check for risk factors. The USPSTF names low body weight, a parent who broke a hip, smoking and drinking too much alcohol. Other conditions and medicines, such as steroids or diabetes treated with insulin, can also raise the risk.
2. If at least one is present, use a risk tool to see whether the risk is raised. If it is, screen with a DXA scan.

One of the tools the USPSTF lists is the Osteoporosis Self-Assessment Tool (OST). It uses only weight and age: (weight in kg minus age in years) times 0.2. A score under 2 is the threshold often used to mark increased risk (USPSTF 2025). For example, a 58-year-old woman who weighs 62 kg (137 lb) scores (62 − 58) × 0.2 = 0.8, under 2. The USPSTF also lists ORAI and FRAX. FRAX estimates the 10-year chance of a fracture and has no set screening cut-off (USPSTF 2025).

What about men?

The USPSTF found the evidence too limited to say whether screening men helps, and leaves it to clinical judgment (USPSTF 2025). It notes that osteoporosis is less common in men (5.7% of men 65 and older, against 27.1% of women) but that men who break a bone from osteoporosis are more likely to die afterwards. It lists risk factors for men too: older age, low BMI, heavy drinking, smoking, long-term steroid use, earlier fractures, a fall in the past year, low testosterone, a past stroke and diabetes (USPSTF 2025).

The Bone Health and Osteoporosis Foundation recommends bone density testing for all men 70 and older, and for men 50 to 69 with risk factors (BHOF 2022).

What the test result means

A DXA scan compares your bone density at the hip or spine with that of healthy young adults. The result is a T-score. A T-score of −2.5 or lower means osteoporosis (USPSTF 2025). Your doctor may also combine the result with FRAX to estimate your fracture risk.

Common questions

At what age should a woman get a bone density test?

At 65, for all women, according to the USPSTF. Postmenopausal women younger than 65 should be screened earlier if they have a risk factor and a risk tool shows increased risk (USPSTF 2025).

How often should a bone density test be repeated?

The USPSTF sets no interval. It notes that repeating the test after 4 to 8 years did not predict fractures better than the first test, and that women with normal bone density took much longer to develop osteoporosis than women whose first T-score was already low (USPSTF 2025). Your doctor decides when to repeat it.

Does Medicare cover a bone density scan?

Coverage depends on your plan and your reason for the test. Ask your plan or your doctor's office before the scan.

I already broke a bone from a minor fall. Is this check for me?

No. A fracture from a fall from standing height or less after 50 can be a sign of weak bones. The Bone Health and Osteoporosis Foundation recommends bone density testing for adults with a fracture (BHOF 2022). Talk to your doctor rather than waiting for screening.

Also see the breast cancer screening check, the colon cancer screening check, the vitamin D and calcium check, the fall risk check and the numbers you need for these checks.