08/21/2026
Osteoporosis isn’t just something that happens to your grandmother.
Bone loss can begin quietly during perimenopause, years before a diagnosis and long before you might think to ask about it.
Estrogen plays an important role in maintaining bone strength by helping slow bone breakdown. As estrogen fluctuates and declines through the menopause transition, bone loss can accelerate, particularly around the final menstrual period and in the years that follow.
And because bone loss is silent, with no pain, obvious symptoms, or early warning signs, many women don’t find out there’s a problem until a bone density scan identifies it or a fracture occurs.
That’s why I want women thinking about bone health earlier, not later.
A DEXA scan is important, but it doesn’t always tell me the whole story. As a physician, I also want to understand what may be contributing to bone loss.
Is declining estrogen playing a role? Is she under fueling? What is her thyroid doing? Are medications or other medical conditions contributing? Does she have a family or fracture history?
Those answers help shape a personalized strategy, rather than simply handing every woman the same calcium and vitamin D recommendations.
Protecting your bones involves more than supplements. I think about weight bearing and resistance exercise, including jumping, weight training, and brisk walking, adequate protein, gut health and nutrient absorption, targeted nutrients based on individual needs, and hormone therapy when appropriate.
Your bones may be changing even if you can’t feel it yet.
Perimenopause gives us an important opportunity to start protecting the strength, mobility, and independence you want decades from now.
The earlier we understand your risk, the more strategic we can be.