Bone Health After Menopause: How to Protect Your Bones Now
Estrogen loss speeds up bone loss after menopause. Know your osteoporosis risk, when to ask about a DXA scan, and how calcium, exercise and fall prevention help
After menopause, the drop in estrogen speeds up bone loss, which raises the risk of osteoporosis and fractures. You can protect your bones by getting enough calcium and vitamin D, doing weight-bearing and strength exercise, avoiding smoking and heavy drinking, preventing falls, and asking your doctor when to get a bone density (DXA) test.
Bone loss is silent. Most women do not feel anything until a fracture happens. The good news is that there is a lot you can do, starting now, to keep your bones as strong as possible.
Why does menopause cause bone loss?
Bone is living tissue that is constantly being broken down and rebuilt. Estrogen helps keep that process in balance. When estrogen falls during the menopause transition, bone is broken down faster than it is replaced. Bone loss tends to be fastest in the first several years after the final period, which is why the menopause years are such an important time to pay attention. The National Institute on Aging explains more about how menopause affects the body.
What raises your risk of osteoporosis?
Some risk factors you cannot change, and some you can.
Risk factors you cannot change:
- Being female and past menopause
- Older age
- A family history of osteoporosis or a parent who broke a hip
- A small, thin frame
- Early menopause, including surgical menopause
Risk factors you can influence:
- Low calcium and vitamin D intake
- Too little physical activity
- Smoking
- Heavy alcohol use
- Low body weight or a history of restrictive eating
- Certain medications, such as long-term steroid use (never stop a prescribed medicine without talking to your doctor)
When should you get a bone density (DXA) test?
A DXA scan is a quick, painless, low-radiation X-ray that measures bone density, usually at the hip and spine. The Bone Health & Osteoporosis Foundation recommends bone density testing for women age 65 and older, and for younger postmenopausal women who have risk factors or who have broken a bone after age 50.
The right timing for you depends on your personal history, so ask your doctor directly: "Based on my risk factors, when should I have a bone density test?" Your doctor may also use a fracture risk calculator to help decide.
How can you protect your bones after menopause?
1. Get enough calcium, mostly from food. Dairy, fortified plant milks, canned salmon or sardines with bones, calcium-set tofu and leafy greens are all good sources. Ask your doctor how much you need and whether a supplement makes sense for you.
2. Get enough vitamin D. Vitamin D helps your body absorb calcium. Fatty fish, eggs and fortified foods help, and your doctor may check your level.
3. Eat enough protein. Protein supports both bone and the muscles that protect you from falls. See our guide to menopause nutrition and foods that help.
4. Move in ways that load your bones. Weight-bearing exercise (walking, dancing, stair climbing) and strength training help maintain bone and muscle. Our exercise during menopause guide includes a simple starter week.
5. Do not smoke, and keep alcohol low. Both are linked with weaker bones.
How do you prevent falls at home?
Most fractures happen because of a fall, so fall prevention is bone protection.
- Remove loose rugs and clutter from walkways
- Add night lights in halls and bathrooms
- Install grab bars in the shower and near the toilet
- Wear supportive, non-slip shoes
- Practice balance exercises like tai chi or standing on one foot near a counter
- Get your vision checked regularly
- Ask your doctor or pharmacist if any of your medications cause dizziness
What treatments are available for osteoporosis?
If testing shows low bone density or osteoporosis, your doctor can talk with you about treatment options, which may include prescription medications and, for some women, menopausal hormone therapy. Every option has benefits and risks, and the right choice depends on your health history. ACOG and The Menopause Society offer patient-friendly information to read before your appointment.
When should you talk to a doctor about bone health?
Talk to your doctor if you:
- Are 65 or older and have never had a bone density test
- Are postmenopausal and have any of the risk factors above
- Have broken a bone from a minor fall after age 50
- Have lost height or notice your upper back is rounding forward
- Have sudden, severe back pain, which can signal a spine fracture
If you want a clinician with special menopause training, use The Menopause Society's practitioner directory.
Bone health questions can feel technical. Valerie, the free AI companion from Her Natural Edge, explains menopause topics in plain language and helps you prepare the questions you want to ask your doctor. She is available any time of day in English, Spanish and Vietnamese. Talk with Valerie at Her Natural Edge. Want the men in your life to understand what you are going through? Point them to Stand In Her Corner.
FAQ
How fast do women lose bone after menopause?
Bone loss is typically fastest in the first several years after the final menstrual period, then slows. The amount varies a lot from woman to woman, which is why a bone density test is the best way to know where you stand.
What is a DXA scan?
A DXA (dual-energy X-ray absorptiometry) scan is a quick, painless test that measures bone density, usually at the hip and spine. It uses a very low dose of radiation and helps your doctor assess your risk of fracture.
Can you rebuild bone after menopause?
Healthy habits help slow bone loss and maintain strength, and some prescription medications can increase bone density. Talk with your doctor about what is right for you based on your test results.
Is walking good for bone health?
Yes. Walking is a weight-bearing exercise that supports bone health. Adding strength training at least two days a week gives your bones and muscles even more support.
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