Greendale GA, Huang M, Cauley JA, et al. - Experts aspired to explore if trabecular bone score (TBS) declines during the menopause transition (MT). Participants in the study were 243 black, 164 Japanese, and 298 white, initially pre- or early perimenopausal women, who experienced their final menstrual period (FMP). TBS loss started 1.5 years before the FMP, decreasing by 1.16% annually. Beginning 2 years after the FMP, the annual TBS loss rate decreased to 0.89%. In the 5 years before through the 5 years after the FMP, the total TBS decline was 6.3% for the reference individual, but the total TBS loss for the black participants was 4.90%. The results for Japanese were no different than those for white women. The occurrence of an MT-related decrease in TBS supports the view that this period is particularly damaging to skeletal integrity.