DEXA Scans, Body Composition, and Bone Health in Perimenopause

If you’ve been following along on Instagram, you saw my recent DEXA update. I had two DEXA scans done about a year apart after really upping my strength training as well as starting HRT. The results: down 3.5 pounds of bodyfat and up 4.2 pounds of muscle. But beyond body composition, one of the most important (and often overlooked) reasons to consider a DEXA scan, especially in perimenopause, is bone health.

Why Bone Health Matters in Perimenopause

As estrogen begins to fluctuate in perimenopause and then decline as we near our final period, women can start losing bone density earlier than expected. This process is often silent, no symptoms, no warning signs, until a fracture occurs years later. The goal is to catch changes early and intervene proactively, not wait until you are 70 with a hip fracture. Spoiler alert: it’s much harder to recover lost bone and fractures can be devastating later in life.

What a DEXA Scan Actually Tells You

A DEXA scan is best known for measuring bone mineral density, but it also provides data on:

• • Lean muscle mass
  • Fat mass and distribution
  • Visceral fat levels

This gives us a much more complete picture of metabolic and musculoskeletal health and is so much better than tracking a number on the scale.

Muscle and Bone Are Connected

Here’s the part I care deeply about for my patients: muscle is protective for bone and it is our organ of longevity.

When you build and maintain muscle, you:

• • Stimulate bone growth through resistance training
  • Improve balance and reduce fall risk
  • Support overall metabolic health

My personal results reflect this, building muscle isn’t just about aesthetics, it’s one of the most powerful tools we have for long-term bone health. And while my number on the scale didn’t really change, the results tell a whole different story!

When Should You Consider a DEXA?

Unfortunately, insurance often doesn’t cover DEXA for women when they are young and healthy but for many women, it makes sense to get a baseline:

• • In your late 30s to early 40s if you’re proactive
  • Earlier if you have risk factors (low body weight, history of amenorrhea, family history of osteoporosis, etc.)
  • Around perimenopause to track trends over time

Fortunately, they are relatively affordable to pay out of pocket and there are many locations across the country where you can walk in without an order to get your DEXA done! In Denver, I got mine (and send patients to) at LiveLeanRx where it takes 10 minutes and they also offer resting metabolic rate testing and Vo2 Max testing so you can get all of the data if you are geek like me!

The Foundation Still Matters Most

Before supplements, biohacking, or even HRT, bone health comes back to the basics:

• • Strength training (non-negotiable)
  • Adequate protein intake
  • Vitamin D and mineral status
  • Hormone optimization
  • Consistent nourishment (not chronic dieting)

DEXA scans are a powerful tool. but they’re just that: a tool. The real impact comes from how you use the data to guide your lifestyle and interventions.

If you’re in perimenopause, this is your window to build, not just maintain, your strength, your muscle, and your bone density for the decades ahead.

If you are looking to up level your health, book a free discovery call with Alison at Well North to get the personalized care you deserve!