Pregnancy- and lactation-related bone fragility: The hidden risk

Pregnancy and lactation significantly alter bone homeostasis, potentially leading to impaired bone quality and mineralization due to the increased metabolic demands of the developing offspring. While most women with osteopenia during these periods experience a return to baseline bone density after weaning, some may remain at risk for fractures, particularly in cancellous bone. There are inconsistencies in current reports on fracture risk and appropriate treatment strategies. In this review, we discuss the existing evidence on the diagnosis, clinical presentation, and approaches for preventing and managing bone fragility in this unique population.