Osteoporosis and Bone Health - Why It Is Silent Until a Fracture and Who Should Be Screened Now
The Wellness is the best place in London to have bone health assessed properly, because osteoporosis is one of the few serious conditions with genuinely no symptoms until the moment it fails, a fracture from a fall that should not have caused one, or a gradual loss of height and a stooped posture from vertebral fractures nobody noticed happening. Around 1 in 2 women and 1 in 5 men over 50 will suffer a fracture related to osteoporosis, and bone density can fall silently for years, most commonly and rapidly around and after the menopause when the protective effect of oestrogen is lost, though it affects men too and is significantly under-recognised in them. A DEXA scan, a low-dose imaging test measuring bone density at the hip and spine, is the only reliable way to find out where you stand before a fracture makes the answer obvious, and it is not part of routine health screening in the UK, so most people are never offered one unless they have already broken a bone. A proper assessment identifies who genuinely needs scanning based on age, menopause status and risk factors, calculates your individual fracture risk, tests the relevant bloods, and builds a plan around bone-protective treatment where it is needed and effective prevention where it is not. Consultations from £150 by video and £220 in person, DEXA scan and bone health assessment from prices below. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Get your bone health assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Why osteoporosis is missed until it is too late
Bone remodels constantly throughout life, old bone broken down and new bone laid down, and for most of adulthood the two processes stay roughly balanced. Around the menopause that balance shifts sharply, because oestrogen protects bone density, and its loss accelerates bone breakdown for several years, so a woman can lose a meaningful proportion of her bone density in the decade around menopause without a single symptom to show for it. Men lose bone density more gradually with age, but osteoporosis in men is real, often more severe by the time it is found, and routinely under-investigated because it is assumed to be a women's condition.
The first sign is very often the fracture itself, a wrist broken in a minor fall that would not normally cause a break, a hip fracture from a stumble, or a vertebral fracture that may cause no dramatic event at all, just a gradual loss of height, a curving upper back, and back pain that gets put down to age or posture. By the time any of these happen, bone density has typically already fallen substantially, which is precisely why waiting for a symptom is the wrong strategy for a condition that has none until it fractures.
Who should actually be screened
Screening is not for everyone, and knowing whether you fall into a group that benefits is useful information in itself. Postmenopausal women, particularly those who went through early menopause before 45 or had their ovaries removed, are the largest group who benefit from proactive assessment, because the years immediately after menopause are when bone loss is fastest. A family history of hip fracture in a parent, particularly a mother, meaningfully raises personal risk and is a reason to be assessed earlier than symptoms would otherwise prompt.
Long-term steroid use, even at doses many people consider low, significantly increases fracture risk and is one of the most common medication-related causes of osteoporosis. Conditions including coeliac disease, inflammatory bowel disease, rheumatoid arthritis, an overactive thyroid or parathyroid gland, and early menopause all raise risk independently of age, as does a low body weight, heavy alcohol use, smoking, and a previous fragility fracture, a break from a fall that should not have caused one, which is itself one of the strongest predictors of another fracture to come. Men over 70, or younger men with any of the risk factors above, are frequently the most under-assessed group of all.
Ask whether you should be screened on WhatsApp or email team@thewellnesslondon.com.
What does bone health assessment involve
A DEXA scan is the test that actually answers the question, a low-radiation imaging scan measuring bone density at the hip and lumbar spine, taking about 10 to 20 minutes, and it produces a T-score that compares your bone density to that of a healthy young adult, which is what defines osteopenia, mildly reduced density, and osteoporosis, more significantly reduced density with meaningfully higher fracture risk. Alongside the scan, a fracture risk calculation using your age, weight, risk factors and, where available, your bone density result estimates your personal 10-year risk of a major fracture, which is what actually guides whether treatment is worthwhile rather than the T-score in isolation.
Blood tests matter alongside the scan, because osteoporosis sometimes has an identifiable and treatable cause behind it rather than being simple age-related bone loss. Vitamin D and calcium, since deficiency directly impairs bone mineralisation and is extremely common, especially by late winter. Thyroid function, since an overactive thyroid accelerates bone loss. Kidney function, liver function and, in men, testosterone, since low testosterone is an under-recognised cause of male osteoporosis. Where the picture suggests it, further tests for parathyroid disease, coeliac disease or an underlying inflammatory condition are added, because finding a reversible driver changes the entire treatment plan.
What actually protects bone density
Weight-bearing and resistance exercise has the strongest lifestyle evidence of anything for maintaining bone density, because bone responds to mechanical load by strengthening itself, and this matters at every age, not just after a diagnosis. Adequate calcium and vitamin D, through diet and supplementation where levels are low, are the foundation nutrients bone actually needs, and correcting a vitamin D deficiency is often the single most impactful and overlooked step. Stopping smoking and moderating alcohol both measurably reduce fracture risk independently of bone density itself.
Where bone density is significantly reduced or fracture risk is high, medication meaningfully reduces fracture risk and is not something to be afraid of, bisphosphonates remain the first-line and most extensively evidenced option for most people, and where they are unsuitable or insufficient, other bone-protective treatments are available and prescribed by specialists. Hormone replacement therapy, for women for whom it is otherwise appropriate around the time of menopause, has a genuine additional bone-protective benefit alongside its other effects, which is one more reason menopause and bone health are best considered together rather than separately. And falls prevention, addressing vision, home hazards, balance and muscle strength, matters as much as bone density itself in preventing the fracture that actually causes harm.
What does bone health assessment cost in London
A DEXA scan at private imaging centres across London commonly costs £150 to £300 as a standalone test, and a consultant rheumatologist or endocrinologist specialising in bone health charges £250 to £450 for a first consultation before any scan or blood test, with follow-up and fracture risk assessment charged separately. Comprehensive imaging and executive programmes at the top of the London market exceed £32,000. Below all of it sits a tier defined by its conditions rather than its price, a scan booked with no clinical context, no fracture risk calculation and no bloods to identify a reversible cause, leaving a number with no plan attached to it.
At The Wellness the assessment, the scan coordination and the plan are 1 fee, and all figures are from prices. The Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, is from £11,995. The women's body scan programme, including imaging, full bloods and review, is from £3,495. The Comprehensive Blood Panel, including vitamin D, calcium, thyroid function, kidney and liver function, with consultation and interpretation, is from £495, and a Targeted Blood Panel from £295. An extended 45-minute consultation for a full bone health review with fracture risk calculation and written plan is from £395. An in-person consultation in Marylebone is from £220, a same-day video consultation from £150 and telephone follow-up from £59. A DEXA scan, coordinated at a specialist imaging centre with consultant reporting, and referral to a named rheumatologist or endocrinologist where bone-protective medication is indicated, are arranged with the appointment booked.
Same-day appointments 7 days a week in Marylebone, 3 minutes from Baker Street.
Why The Wellness is the best place in London for bone health
Because you are told plainly whether you are in a group that actually benefits from screening, rather than either being scanned without reason or missed because nobody asked. Menopause status, family history, steroid use and the other risk factors are worked through deliberately, and men, who are so often left out of this conversation entirely, are assessed on the same basis as women.
Because the scan comes with a plan rather than a number. Fracture risk is calculated from your age, weight and risk factors together with your bone density, which is what actually determines whether treatment is worthwhile, and bloods are checked in the same round to find the reversible causes, a vitamin D deficiency, an overactive thyroid, low testosterone, that sometimes explain the result and change what happens next.
And because treatment, where it is needed, is genuinely started rather than deferred indefinitely. Bone-protective medication is explained honestly, weight-bearing exercise and nutrition are given as concrete, individualised advice rather than a generic leaflet, and where menopause and bone health intersect, both are considered together rather than as separate problems requiring separate appointments.
Book a bone health assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What are the symptoms of osteoporosis
Usually none until a fracture happens. A wrist, hip or vertebral fracture from a fall that should not have caused a break is often the first sign, alongside gradual height loss and a stooped posture from vertebral fractures that may cause no dramatic event at all. This is why screening rather than waiting for symptoms is the right approach for those at risk.
Who should have a DEXA scan
Postmenopausal women, particularly those with early menopause before 45, anyone with a parent who had a hip fracture, long-term steroid users, people with coeliac disease, inflammatory bowel disease or an overactive thyroid, those with a previous fragility fracture, and men over 70 or younger men with these risk factors.
What is the difference between osteopenia and osteoporosis
Both are measured by a DEXA scan T-score comparing your bone density to a healthy young adult. Osteopenia is mildly reduced density, and osteoporosis is more significantly reduced density carrying meaningfully higher fracture risk. Fracture risk is calculated from more than the T-score alone, including age, weight and other risk factors.
Can osteoporosis be reversed
Bone-protective medication can meaningfully increase bone density and substantially reduce fracture risk, and correcting an underlying cause such as vitamin D deficiency or an overactive thyroid can improve the picture further. Weight-bearing exercise, adequate calcium and vitamin D, and stopping smoking all measurably help at any stage.
Does osteoporosis only affect women
No. Around 1 in 5 men over 50 will suffer a fracture related to osteoporosis, and it is significantly under-recognised and under-investigated in men, who are often diagnosed later and with more severe bone loss than women because screening is rarely offered to them proactively.
Is HRT good for bone health
Yes, for women for whom hormone replacement therapy is otherwise appropriate around menopause, it has a genuine additional bone-protective effect alongside its other benefits, which is one reason menopause and bone health are best assessed together rather than as entirely separate issues.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Blood analysis is performed by accredited laboratories, and DEXA scanning and specialist bone health treatment are arranged at specialist centres and reported by consultants. Sudden severe back pain after a fall, or any fracture from a minor injury, needs prompt assessment. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE guideline CG146 on osteoporosis, assessment of fracture risk, and NICE technology appraisals on bisphosphonates and other bone-protective treatments. National Osteoporosis Guideline Group clinical guideline for the prevention and treatment of osteoporosis. Royal Osteoporosis Society data on osteoporosis prevalence in UK men and women. Published evidence on the FRAX fracture risk assessment tool. British Menopause Society guidance on hormone replacement therapy and bone health. Published 2026 London private DEXA scanning and bone health market pricing.
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