Bone Health Counseling — Protecting Bone Density Before and After Menopause
Women lose bone density at an accelerated rate in the years immediately following menopause — up to 20% of total bone mass in the first 5–7 postmenopausal years. This loss is largely silent. There are no symptoms until a fracture occurs. Bone health counseling at Lapeer Women’s Health addresses that gap — evaluating your current bone status, identifying your personal fracture risk, and establishing a prevention or treatment plan before a fragility fracture happens.
Dr. Andrei incorporates bone health assessment into the care of perimenopausal and postmenopausal patients as a standard component of gynecologic care — not an afterthought. DEXA scan results are reviewed in clinical context, calcium and vitamin D status are assessed, and the role of hormone therapy, bisphosphonates, and other bone-active agents is discussed based on your individual risk profile.
Bone health is not exclusively a postmenopausal concern. Women with a history of amenorrhea, eating disorders, prolonged corticosteroid use, premature ovarian insufficiency, or low body weight are at elevated risk at any age. Dr. Andrei identifies these risk factors at your visit and addresses them proactively.
Bone Health Assessment — What Dr. Andrei Evaluates
Bone health counseling addresses your current bone status, your personal risk factors, and the interventions most likely to protect your skeleton over the long term.
DEXA scan interpretation
Dual-energy X-ray absorptiometry (DEXA) measures bone mineral density at the hip and lumbar spine. Dr. Andrei reviews your T-score and Z-score, explains what they mean in plain language, and places the results in the context of your age, menopausal status, and other risk factors — not just whether the number falls in the “normal” range.
FRAX fracture risk assessment
The FRAX tool calculates your 10-year probability of major osteoporotic fracture and hip fracture based on DEXA results combined with clinical risk factors. Dr. Andrei uses FRAX to determine whether your fracture risk crosses the threshold at which pharmacologic treatment is recommended — regardless of whether your DEXA meets the technical definition of osteoporosis.
Calcium and vitamin D assessment
Adequate calcium and vitamin D are the foundation of bone health at every age. Dr. Andrei reviews your dietary calcium intake, current supplementation, and serum 25-OH vitamin D level. Vitamin D insufficiency is common and independently worsens bone loss — correction is a first-line intervention before any medication is considered.
Hormone therapy and bone protection
Estrogen is bone-protective — it significantly reduces bone loss and fracture risk when initiated at or near menopause. For patients already on hormone therapy, Dr. Andrei discusses its contribution to bone protection. For patients not on hormone therapy, bisphosphonates and other agents are discussed based on DEXA and FRAX results.
Pharmacologic treatment options
When DEXA and FRAX indicate treatment is appropriate, Dr. Andrei discusses bisphosphonates (alendronate, risedronate, zoledronic acid), RANK-L inhibitors (denosumab), SERMs (raloxifene), and anabolic agents — explaining mechanism, frequency, duration, and monitoring for each class before prescribing.
Fall risk and lifestyle factors
Fracture prevention is not only about bone density — fall prevention is equally important. Dr. Andrei discusses weight-bearing and resistance exercise, balance training, home safety, and medication review for agents that increase fall risk as part of a comprehensive bone health strategy.
DEXA Screening — Who Needs It and When
DEXA screening guidelines are clear for most patients, but risk factors can justify earlier or more frequent screening. Dr. Andrei applies these criteria at every relevant visit.
- All women age 65 and older — regardless of risk factors, per USPSTF recommendation
- Postmenopausal women under 65 with clinical risk factors — early menopause, family history of hip fracture, low body weight, smoking, chronic steroid use
- Women with premature ovarian insufficiency — early estrogen loss accelerates bone loss significantly
- Women with a history of amenorrhea lasting more than 6 months — athletic or eating disorder related
- Women on chronic aromatase inhibitors for breast cancer — profound estrogen suppression requires bone monitoring
- Repeat DEXA every 1–2 years when on bone-active treatment; every 2–5 years for stable low-risk patients
“A hip fracture in an older woman is not just a broken bone. It is a life-changing event with a one-year mortality rate approaching 25%. Most of those fractures are preventable. That is why I take bone health seriously in every perimenopausal and postmenopausal patient I see — not as an add-on, but as a core part of gynecologic care.”
- DEXA scan referral coordinated at your office visit — ordered and results reviewed at LWH
- Calcium and vitamin D optimization before any prescription medication is initiated
- Bisphosphonate prescriptions managed at LWH with appropriate monitoring interval
- Endocrinology referral coordinated when complex osteoporosis management is indicated
- Bone health integrated into the menopause care program for patients in ongoing management
Questions About Bone Health Counseling
Bone Loss Is Silent.
Prevention Does Not Have to Be.
Bone health counseling with Dr. Andrei — DEXA interpretation, fracture risk assessment, calcium and vitamin D review, and a prevention or treatment plan tailored to your risk profile.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.