Across the lifespan, women have unique health issues necessitating specialized medical and rehabilitative care. The role of PMR in prevention, management and recovery from these issues is recognized. Osteoporosis affects over 30% of postmenopausal women in the US and this is increasing as the population ages. Adult bone density is determined in the peri-pubertal years essentially defining osteoporosis as a disease originating in childhood. The impact of lifestyle, diet and exercise on bone health and osteoporosis risk in the pediatric peri-pubertal, as well as in pre-menopausal women, will be presented as an opportunity for PMR to have a significant positive impact on the course of this disease. Osteoporosis related fracture causes significant burden: over 1.5 million fractures annually in the US and 500,000 related hospitalizations and an annual cost estimate of over $25 billion by 2025. Prevention of post-menopausal osteoporosis and its related disability is an achievable goal for Physiatrists and rehabilitation programs. We will review the rehabilitative approach to optimize bone density, maintain strength and flexibility, and prevent falls. The integration of an osteoporosis prevention and rehabilitation program will be discussed.