In Singapore, clinical guidance recommends that all women past menopause have their osteoporosis risk assessed. Your doctor usually starts with a quick risk score based on your age and weight, then suggests a bone density scan if your risk is moderate or high. Screening matters because osteoporosis causes no symptoms until a bone breaks, and earlier detection gives you time to act.
Key takeaways
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Osteoporosis means your bones have become thinner and weaker, so they break more easily, often from a simple fall.
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Women lose bone faster after menopause because levels of oestrogen, a hormone that helps protect bone, drop.
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Singapore's Agency for Care Effectiveness (ACE) guidance recommends osteoporosis risk assessment for all postmenopausal women.
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The test used to diagnose osteoporosis is a DXA scan of the hip and spine, which gives a result called a T-score.
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Weight-bearing exercise, enough calcium and vitamin D, not smoking and limiting alcohol all help protect your bones.
What is osteoporosis and why does it affect women more?
Osteoporosis is a condition where bones lose density and strength, so they become fragile. It is often called a silent condition because you cannot feel your bones thinning, and the first sign may be a fracture of the wrist, spine or hip.
Women are more likely to develop it for two main reasons. They tend to build less bone mass than men by early adulthood, and they lose bone more quickly in the years around menopause, when oestrogen levels fall. The International Osteoporosis Foundation estimates that around 1 in 3 women over 50 worldwide will have a fracture caused by osteoporosis.
A broken hip in later life can affect independence and mobility, which is why doctors focus on finding weak bones before a fracture happens.
Who should be screened for osteoporosis in Singapore?
Singapore guidance recommends that all postmenopausal women, and men aged 65 and above, have their risk of osteoporosis assessed. Assessment does not always mean a scan straight away. It usually starts with a conversation about your risk factors.
Your risk may be higher if you:
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Have gone through menopause, especially if it was early (before 45)
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Have a low body weight or small frame
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Have a parent who broke a hip
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Have had a fracture from a minor fall as an adult
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Smoke or drink alcohol regularly
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Have taken steroid tablets for three months or longer
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Have conditions that affect bone, such as an overactive thyroid, rheumatoid arthritis or conditions that affect how you absorb food
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Are not very physically active, or get little calcium or vitamin D
If any of these apply to you before menopause, it is worth raising bone health with your doctor earlier.
How is osteoporosis risk assessed and tested?
Doctors in Singapore commonly use a simple tool called the Osteoporosis Self-Assessment Tool for Asians (OSTA), which uses your age and weight to estimate your risk. Depending on the score and your other risk factors, you may be advised to have a bone density test.
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Test |
What it involves |
What it is used for |
|---|---|---|
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OSTA risk score |
A quick calculation using your age and body weight |
Deciding who is likely to benefit from a bone density scan |
|
Heel ultrasound (calcaneal ultrasound bone densitometry) |
Your heel rests in a small device for a few minutes; no radiation |
A quick screening check of bone density; a low reading usually leads to further testing |
|
DXA scan (dual-energy X-ray absorptiometry) |
You lie on a table while a scanner passes over your hip and spine; uses a very low dose of X-rays |
Confirming a diagnosis of osteoporosis and tracking changes over time |
|
Blood tests |
Calcium, vitamin D and other markers |
Looking for other causes of bone loss |
At Fusion Medical, some women's health screening packages include a calcaneal ultrasound bone density test, such as the Fusion Breast & Women's Health package. Bone density is usually checked as part of a wider review, so it is worth comparing health checkup packages in Singapore and choosing one that covers the areas most relevant to you. Your doctor can explain what your result means and whether a DXA scan is the right next step.
What do bone density results mean?
A DXA scan compares your bone density with that of a healthy young adult and gives a T-score. The lower the number, the thinner your bones.
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T-score of -1.0 or higher: normal bone density
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T-score between -1.0 and -2.5: low bone mass, sometimes called osteopenia, which means your bones are thinner than ideal but not yet in the osteoporosis range
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T-score of -2.5 or lower: osteoporosis
A fracture from a minor fall, such as tripping at home, can also lead to a diagnosis of osteoporosis even if the T-score is not in that range. Your doctor will look at your T-score alongside your age, risk factors and fracture history to decide what, if anything, is needed next.
What can you do to protect your bones?
Everyday habits make a real difference to bone strength at any age. They help build bone in younger women and slow bone loss after menopause.
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Stay active with weight-bearing exercise. Brisk walking, stair climbing, dancing and light jogging put healthy stress on your bones. Add strength training two or more days a week.
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Work on your balance. Tai chi and balance exercises lower your risk of falls, which is the main way fractures happen.
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Get enough calcium. ACE guidance recommends 1,000 mg of calcium a day for adults aged 51 and above. Good local sources include milk, yoghurt, calcium-set tofu, ikan bilis and dark green leafy vegetables.
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Check your vitamin D. Vitamin D helps your body absorb calcium. Many people in Singapore spend most of the day indoors, so ask your doctor whether a test makes sense. Our article on vitamin D deficiency explains more.
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Avoid smoking and limit alcohol, as both speed up bone loss.
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Make your home safer. Good lighting, non-slip mats in the bathroom and clear walkways reduce fall risk.
If you have been diagnosed with osteoporosis, your doctor may also discuss medicines that slow bone loss or help rebuild bone. The right choice depends on your health and fracture risk.
When should you speak to a doctor about bone health?
Speak to a doctor if you have reached menopause and have never had your bone health checked, or if you have any of the risk factors above. You should also see a doctor if you have had a fracture from a minor fall, have lost height, or notice your upper back becoming more rounded, as these can be signs of spinal fractures.
Menopause is a good time to review bone health alongside other changes. Our page on perimenopause and menopause covers other symptoms to look out for, and the Fusion Perimenopause & Menopause screening includes a bone density check.
Frequently asked questions
At what age should women get a bone density test in Singapore?
There is no single age for everyone. Singapore guidance recommends risk assessment for all postmenopausal women, and your doctor will suggest a bone density scan if your risk score or history points to a higher risk. Women with risk factors before menopause may need testing earlier.
Is a bone density scan painful or risky?
A DXA scan is quick and you simply lie still on a table. It uses a very low dose of X-rays. A heel ultrasound uses no radiation at all. Let the staff know if you are, or may be, pregnant.
Can osteoporosis be reversed?
Bone loss can be slowed, and some treatments can help increase bone density, lowering the chance of fractures. Exercise, nutrition and, where needed, medicine all play a part. Your doctor will explain what is realistic for you.
Do I need calcium supplements?
Not everyone does. Many people can reach their calcium needs through food. Your doctor may suggest a supplement if your diet is low in calcium, you have osteoporosis, or your vitamin D level is low.
How often should bone density be rechecked?
This depends on your first result and whether you are on treatment. People with normal results and few risk factors may not need frequent repeat scans, while people on treatment are often rechecked every one to two years. Your doctor will advise.
This article is for general information only and is not a substitute for medical advice. Please consult a qualified doctor in Singapore for advice specific to your situation.
