DEXA scan

Bone adapts to the specific mechanical forces placed on it, not just to how much you move in general. Walking is great for overall health, but it mostly loads the legs in a mild, repetitive way — it doesn't put strong, varied loading through the spine or hip in the way those sites actually need to maintain their density.

Not necessarily — bone density is only part of the picture. A higher density score is a good sign, but fracture risk also depends on bone geometry, cortical thickness, and the internal trabecular architecture, which a density score alone doesn't fully capture. In fact, many fragility fractures happen in people whose scans fall in the normal or osteopenic range.

Your bones didn't literally "fall off a cliff" — but it can feel that way because menopause causes a real, well-documented drop in bone density over a fairly short window. The key reason is estrogen: it normally keeps bone-removing cells (osteoclasts) in check, and when estrogen drops at menopause, those cells become overactive while the bone-building cells can't keep pace.

A T-score compares your bone density to that of a healthy young adult, measured in standard deviations: -1.0 and above is normal, -1.0 to -2.5 is osteopenia, and -2.5 or below is osteoporosis. But it's just one snapshot of density — it doesn't capture bone quality, your fall risk, or your overall fracture probability, so it's worth tracking several other things alongside it and discussing them with your physician.

Not in the same way you did while building. Bone is living tissue that adapts to the demands you place on it, so once you've reached your goals, you generally need less intensity than during the building phase — but you do need to keep giving your skeleton some ongoing signal to preserve what you gained. How that looks long-term is personal to you.