The EngagED Midwife

Osteoporosis Unmasked: Midwives on Screening, Risk, and Real Prevention


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A fracture rarely starts with drama. It’s often a quiet misstep, a stumble off a curb, or a slip on a throw rug—and that’s exactly why bone health deserves our full attention. We’re taking a clear, practical tour through osteoporosis and osteopenia: what they are, why they’re “silent,” and how to get ahead of them with smart screening, daily habits, and targeted treatments.

We unpack the biology of bone remodeling—osteoclasts that break down old bone and osteoblasts that build new—and the outsized role estrogen plays as it declines through perimenopause and menopause. You’ll hear exactly who should get a DEXA scan at 65 and who needs it earlier based on risk factors like prior adult fractures, long-term steroid use, low body weight, family history, or conditions like hyperthyroidism, celiac disease, and rheumatoid arthritis. We demystify T-scores versus Z-scores so you can read your results with confidence and know where osteopenia ends and osteoporosis begins.

From there, we get tactical. Nutrition that actually moves the needle, weight-bearing exercise and resistance training you’ll actually do, and when medication is actually warranted.  We round it out with fall prevention you can implement today: balance training, better lighting, grab bars, safer footwear, and a clutter-free path through your home. If you care about staying strong, steady, and independent, this conversation gives you the tools. 

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The EngagED MidwifeBy Cara Busenhart and Missi Stec

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