Summary
May is Osteoporosis Awareness Month—a timely reminder that bone loss can begin earlier than many women realize, especially during the menopausal transition. In this article, Mary Cabell, DNP, shares findings from a Couri Center clinical project showing how early screening can detect previously undiagnosed bone loss and help guide proactive care.
Early Postmenopause & Bone Health: What a New Screening Project Revealed
By Mary Cabell, DNP, MSN, APRN, FNP-C @couricenter
Why Earlier Osteoporosis Screening Matters
As many of our patients know, last summer I completed a clinical project at the Couri Center as part of my Doctor of Nursing Practice (DNP) degree, focused on improving osteoporosis screening in women during early postmenopause. In recognition of Osteoporosis Awareness Month, this topic is especially important to highlight now.
One of the reasons I chose this topic was due to a recent update from the United States Preventive Services Task Force (USPSTF), an independent panel of experts that provides evidence-based recommendations on preventive healthcare. Their updated Recommendation Statement on Osteoporosis expanded screening guidance for women earlier in the postmenopausal transition.
This update is important because the most rapid rates of bone loss occur during menopause, yet women in early postmenopause are often overlooked. The International Menopause Society has also emphasized the need to shift osteoporosis prevention earlier in the menopausal transition.
About the Screening Project
The goal of my project was to determine whether osteoporosis screening rates in early postmenopausal women could be improved through the use of a formal screening tool.
To support this effort, I selected the FRAX® tool, a validated and widely used, web-based fracture risk assessment calculator.
What Is FRAX?
FRAX is a screening tool that helps providers estimate a patient’s risk of fracture by evaluating factors such as:
- Menopausal status
- Family history of osteoporosis
- Certain medical conditions
- Use of medications that affect bone health
Tools like FRAX help providers determine whether a patient meets criteria for bone density screening.
How Patients Participated
Women between the ages of 40 and 64 who presented for their annual well-woman exam were invited to participate in the project.
Participants received:
- Educational materials explaining osteoporosis and bone health
- QR codes linking to menopause-related bone health resources
- A FRAX screening questionnaire assessing individual risk factors
Women who met risk-factor criteria were offered a DXA scan—a specialized X-ray that measures bone mineral density and helps diagnose bone loss.
Screening Results: What We Found
The project was conducted over a 12-week period (June–August).
- 575 women completed the screening questionnaire
- 186 women met criteria for DXA screening
- 97 women chose to complete a DXA scan
DXA Scan Findings
Among the 97 women who completed a DXA scan:
- 33 women were diagnosed with osteopenia (mild bone loss)
- 4 women were diagnosed with osteoporosis (more significant bone loss)
38% of women who completed a DXA scan had previously undetected bone loss.
Why These Findings Are Significant
To better understand the impact of the screening tool, project data was compared to DXA scans completed during the same timeframe in 2024.
A Chi-square statistical analysis (a test that compares expected versus observed outcomes) was used to evaluate differences between normal and abnormal DXA results.
The findings showed that implementing a formal screening tool was statistically significant—meaning structured screening did, in fact, improve osteoporosis detection in early postmenopausal women.
While statistical significance was not required for the project, it was encouraging to see meaningful, measurable improvements in identifying bone loss earlier.
What This Means for Women’s Health
This project reinforced how important earlier, individualized osteoporosis screening can be—especially during the menopausal transition, when bone loss accelerates.
Identifying risk sooner allows providers and patients to have proactive conversations about:
- Bone health
- Lifestyle and prevention strategies
- Treatment options when appropriate
- Long-term fracture risk reduction
New patients are always welcome.
To learn more about bone health, osteoporosis screening, or to schedule an appointment, please call the Couri Center at 309-692-6838 or request an appointment online BELOW:
Acknowledgments
I would like to personally thank Dr. Michele Couri for her generosity and support throughout this project. I am also grateful to the staff, nurses, and providers whose encouragement and collaboration made this work possible.
Mary Cabell, DNP, MSN, APRN, FNP-C
About the Author
Mary Cabell, DNP, APRN is a Doctor of Nursing Practice at the Couri Center for Gynecology & Integrative Women’s Health. She is passionate about evidence-based prevention and advancing women’s health through early, individualized screening and education.
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DISCLAIMER: This article is for educational purposes only. Nothing here should be considered medical advice. Please consult your healthcare provider or schedule with the Couri Center if you need personalized care.
References
- FRAX® Calculator: https://www.fraxplus.org/calculation-tool
- International Menopause Society – Osteoporosis Prevention: https://www.youtube.com/watch?v=mNpD1F48PwU
Kahwati LC, et al. Screening for Osteoporosis to Prevent Fractures. JAMA. 2025.
https://doi.org/10.1001/jama.2024.21653