Bone density scan - when should I get one?

A bone density scan (bone mineral density, BMD) is recommended in these scenarios per Ministry of Health Malaysia Osteoporosis CPG 2022 and North American Menopause Society: (1) All women 65+ - routine screening without additional risk factors. (2) Postmenopausal women 50-64 with risk factors: adult fracture history (especially hip, spine, or wrist), low body weight (body mass index < 19), smoking, heavy alcohol use, long-term steroid use (>3 months), family history of hip fracture, or premature menopause (before 45). (3) Women newly diagnosed with conditions raising osteoporosis risk: hyperthyroid, rheumatoid arthritis, chronic kidney disease, or Type 1 diabetes. (4) Women planning hormone replacement therapy or monitoring osteoporosis treatment response. Bone density scan cost in Malaysia: at a government hospital with Ministry of Health Malaysia referral, current rates vary by facility; at a private hospital, RM200-400. T-score interpretation: (a) > -1.0 = normal. (b) -1.0 to -2.5 = osteopenia (early bone loss). (c) < -2.5 = osteoporosis. After the first bone density scan, repeat every 2 years if treatment started, or every 3-5 years for routine monitoring without treatment. Sites commonly tested: lumbar spine, hip, and sometimes forearm. Without a referral, a bone density scan isn't typically covered by insurance - consider it if you have multiple risk factors.