REMS bone density in pre- and postmenopausal women
Comparing bone loss before and after menopause
Kirilova, Kirilov, Popov & Vladeva. Clinical Cases in Mineral and Bone Metabolism 16(1) (2019) 14–17.
165
Women scanned with REMS across two centers
p < 0.01
Lower BMD in postmenopausal women, every site tested
Osteopenic
Premenopausal women's own femoral neck BMD range
First of its kind
First study comparing REMS BMD by menopausal status
Why this study matters for your bone health
Menopause is when bone loss accelerates the most — falling estrogen levels significantly increase bone resorption, and the years around and after menopause are when many women first cross into osteopenia or osteoporosis. This study set out to confirm that REMS, a radiation-free alternative to DXA, could detect that same well-established pattern.
Researchers at two Bulgarian centers scanned 165 women — 25 premenopausal (average age 43) and 140 postmenopausal (average age 65) — measuring REMS-based bone density at the lumbar spine, femoral neck, trochanter, and total hip. It was the first study to compare REMS bone density specifically between these two groups.
The result matched the pattern that decades of DXA research has already established: postmenopausal women showed significantly lower bone density than premenopausal women at every single site measured — the lumbar spine (each of the four vertebrae and the total), the femoral neck, the trochanter, and the total hip.
What it means in practice: a REMS scan tracks bone loss through menopause the same way DXA does — giving your physician a reliable, radiation-free way to monitor this most vulnerable window for bone health, and to catch changes as they happen rather than after a fracture.
One additional finding is worth knowing about even before menopause: the premenopausal women in this study, despite having healthier bone density overall, still had a mean femoral neck BMD that fell within the osteopenic range. The authors note this is consistent with other research showing femoral neck bone loss can begin earlier in life than lumbar spine loss — a reminder that bone density monitoring has value well before menopause, not only after it.
What the study found
Four findings, in plain language.
- 1
Lumbar spine density was significantly lower after menopause
At every lumbar vertebra measured (L1 through L4) and in the total lumbar spine reading, postmenopausal women showed significantly lower REMS-based bone density than premenopausal women (p < 0.001 at every level) — a clear, consistent signal across the entire spine.
- 2
Hip and femoral neck density followed the same pattern
Femoral neck density (p = 0.011), trochanteric density (p = 0.007), and total hip density (p = 0.009) were all significantly lower in postmenopausal women — confirming the pattern held at the hip as well as the spine.
- 3
REMS's results matched what DXA studies have long shown
The authors note that other studies comparing premenopausal and postmenopausal bone density using DXA have reported similar findings — REMS reproduced an already well-established clinical pattern, using ultrasound instead of radiation.
- 4
Femoral neck bone loss may start before the lumbar spine's
Premenopausal women's femoral neck density, while significantly higher than postmenopausal women's, still fell within the osteopenic range on its own. Referencing prior research, the authors suggest femoral neck bone loss can begin as early as the 30s, ahead of when lumbar spine loss typically starts.
Study details
- Full title
- Bone mineral density of lumbar spine and femoral neck assessed by novel echographic approach-Radiofrequency Echographic Multi Spectrometry (REMS)
- Authors
- Elena Kirilova, Nikola Kirilov, Iliya Popov, Stoyanka Vladeva
- Journal
- Clinical Cases in Mineral and Bone Metabolism, volume 16, issue 1 (2019), pages 14–17
- Population
- 165 women across two Bulgarian centers: 25 premenopausal (mean age 43) and 140 postmenopausal (mean age 65)
- Comparison
- REMS-based bone density of the lumbar spine and hip in premenopausal vs. postmenopausal women
- Key result
- Postmenopausal women had significantly lower REMS-based BMD at L1–L4, total lumbar spine, femoral neck, trochanter, and total hip (p ≤ 0.011 at every site)
- Noted limitation
- The authors flag natural soft-tissue variability between patients, and that REMS in this study analyzed only the trabecular bone region rather than cortical bone, as limitations of the approach
Track your bone health through every stage
A REMS bone density scan takes about 15 minutes and uses no radiation — making it safe to repeat as often as your physician recommends, whether you're monitoring changes before menopause or tracking bone loss after it. Serving patients across New York and New Jersey.
- No radiation at any point during the scan
- Detects the same bone loss patterns established DXA research shows
- Safe to repeat for monitoring as often as your physician recommends
More published research on REMS technology is collected on the research library page.