Menopause and Bone Health: What You Need to Know
Menopause can accelerate bone loss and raise osteoporosis risk. Learn steps you can take to keep your bones healthy and strong.
By Rachel Kramer, MD, FACOG, OB/GYN, Virtua Menopause and Midlife Center
Night sweats, hot flashes, mood changes, difficulty concentrating, and vaginal dryness are all familiar symptoms of menopause. For many women, the transition to menopause also brings along bone loss that can lead to osteoporosis.
Estrogen is one of the hormones essential to new bone growth. When estrogen levels drop, particularly in the first years after your last period, you tend to lose the most bone, increasing your risk of a fracture.
What’s my osteoporosis risk?
Our bones are constantly changing. The body breaks down old bone and grows new bone to take its place. Estrogen promotes the creation of osteoblasts, the cells that make new bone.
Bone density increases until around age 30, and then begins to slowly decline. Having low estrogen levels can speed this process, which is why women going through menopause lose bone density faster than men.
Risk factors for developing osteoporosis include:
- A family history of osteoporosis
- A small or thin body frame
- Smoking
- Excessive drinking
- Having rheumatoid arthritis
- Early or premature menopause
Osteoporosis-related fractures affect more women than breast and uterine cancer. So knowing your risk, and taking steps now to improve your bone health, is essential to your quality of life down the road.
How do I strengthen my bones?
Because osteoporosis does not produce symptoms, clinicians rely on a dual-energy X-ray absorptiometry (DEXA) scan to detect decreased bone mass. In its earliest stages, the loss of bone mass is called osteopenia. As bones get more porous and weak, it’s called osteoporosis.
I recommend women receive a DEXA scan as soon as they begin menopause, although insurance coverage may vary.
To prevent osteoporosis or slow its progression:
Eat a variety of calcium-rich foods such as dairy products, salmon and green, leafy vegetables.
Try to eat about 1,200 milligrams a day. If your diet lacks calcium, talk to your clinician about taking a calcium supplement. Because vitamin D helps your body absorb calcium, they will likely recommend taking a vitamin D supplement or a supplement that combines calcium with vitamin D.
Do weight-bearing exercises, such as walking, running, dancing, pickleball, and jumping jacks.
In fact, any exercise that includes a heel strike sends signals to your body to create more bone. Mix in strength training and weightlifting—you don’t need a fancy gym—at least three times a week to build bone-protecting muscle.
Consider hormone replacement therapy (HRT).
Estrogen-only HRT and progesterone and estrogen combination therapy come in pills, patches, skin creams, and gels. Bioidentical hormone replacement therapy (BHRT) uses hormones derived from plant-based compounds that identically match human hormones are delivered through a pellet placed under the skin.
A hip or spine fracture can significantly impact your mobility and independence. Every woman who is entering menopause should know their risk and discuss options with their clinician.
Take the next step to improve your bone health
- Schedule an appointment to talk to your primary care provider about your bone health and what you can do to keep your bones strong.
- Learn more about all your menopause treatment options and how hormone replacement therapy can support your overall health.
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