STOP performing DXA scans in healthy, perimenopausal women START counseling all women on lifestyle interventions to avoid fractures

The authors report no financial relationships relevant to this article.

CASE: Premature treatment for osteopenia

A 57-year-old woman presents to establish care and discuss concerns related to menopause and osteoporosis management. She is G2P2, healthy, 5 ft 6 in, and 130 lb. She underwent natural menopause at age 51; her vasomotor symptoms have been mild, and she has not used hormone therapy. Upon annual physical examination at age 52, her former physician referred her for a mammogram, bone-density assessment, and colonoscopy. Osteopenia (femoral neck T-score, –1.8) was noted on dual-energy x-ray absorptiometry (DXA), and alendronate 70 mg per week was started.

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