Osteoporosis may present after menopause, but prevention starts decades earlier. In this episode of BackTable Women’s Health, Dr. Carla Gunn, guest host and OBGYN, interviews Dr. Pooja Luthra, an endocrinologist at UConn Health, about osteopenia, osteoporosis, and practical strategies for lifelong bone health.

---

Get the BackTable app

https://www.backtable.com/app

---

Timestamps

00:00 - Introduction
03:28 - Why Bone Health Matters Early
05:23 - Bone as a Vital Sign
08:02 - Amenorrhea and Early Screening
09:51 - Calcium, Vitamin D, and Protein
15:11 - Menopause Bone Biology Explained
21:58 - Metabolic Diseases and Bone Risk
25:58 - Early Screening Red Flags
27:53 - Hormone Therapy Bone Benefits
30:59 - Reading DEXA Scores
33:42 - FRAX Scores
35:09 - Modern Treatment Sequencing
38:02 - Bisphosphonates Mechanism and Concerns
41:16 - Secondary Labs and Referrals
44:23 - Closing Thoughts

---

More about this episode

Dr. Luthra explains how peak bone mass is largely established by early adulthood, followed by accelerated loss during the perimenopausal/menopausal transition due to estrogen decline, inflammatory cytokines, altered calcium absorption, and increased bone resorption. She reviews prevention strategies, including adequate calcium, vitamin D, and protein intake, resistance training, and avoiding smoking and excess alcohol use. The discussion also covers high-risk conditions that can negatively impact bone health, including amenorrhea, premature ovarian insufficiency, hyperthyroidism, diabetes, and chronic kidney disease, along with considerations for earlier screening in these patients. Dr. Luthra walks through DEXA interpretation, including T-scores, Z-scores, trabecular bone score (TBS), and FRAX assessment. She closes the conversation by outlining treatment sequencing with anabolic agents before antiresorptives, bisphosphonate safety, alternative therapies, and secondary osteoporosis workup labs.

---

Resources

FRAX Tool:
https://www.fraxplus.org/calculation-tool

---

BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.

Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.

► https://www.backtable.com/app