How menopause affects your bones

Your bones may not be the first thing you think of when it comes to menopause, but there’s an important connection that all women should know about. 

When you go through menopause, your estrogen levels drop drastically. Since estrogen helps maintain bone density, this decrease can lead to faster bone resorption (breakdown of bone tissue) and bone loss, which puts one at higher risk of osteoporosis, a condition in which the bones become weaker and more fragile. 

Roughly 1 in 2 women over age 50 will break a bone due to osteoporosis, according to the Bone Health & Osteoporosis Foundation.

Osteopenia vs. osteoporosis

There are two key terms when it comes to bone health:

  • Osteopenia refers to having bone mineral density that is lower than normal, which is an indication that you have a higher risk for breaking a bone.
  • Osteoporosis is diagnosed when your bone density is low enough that your bones can easily break. About 80% of those living with osteoporosis in the U.S. are women.

Testing your bone density

Bone mineral density (BMD) is a way to measure how strong and healthy your bones are. While you can start to lose bone mass during perimenopause (or earlier), your risk of a major decrease in BMD is greatest the year before your last menstrual period and several years after menopause. From there, the rate of bone loss typically slows.  

Depending on your age, risk factors, and availability of testing, your healthcare provider may first complete a clinical fragility risk assessment. They may also order a DEXA or DXA scan (dual-energy x-ray absorptiometry), a painless test that uses low levels of X-rays to measure bone mineral density at the hip and spine. 

A DEXA scan can definitely diagnose osteoporosis, and it is generally recommended (and covered by health insurance plans) every two years for women over age 65. DEXA scans may be initiated earlier than age 65 based on risk factors such as prior fracture, weight, being on certain medications, and other factors. If your initial scan shows that your bones are healthy, however, your healthcare provider may recommend a different timeline. 

Preventive measures are key

The good news is that there are several things you can do to help keep your bones strong, including:

  • Ensuring you’re getting 1,200 mg/day of calcium through diet and supplements
  • Taking vitamin D supplements as well to support your bone health
  • Maintaining a healthy weight, avoiding smoking, and reducing alcohol intake
  • Developing and maintaining good posture when sitting and standing
  • Incorporating weight-bearing, strength-training, and balance exercises
  • Ensuring your home environment is free from fall hazards 

Exercise and bone health

Research shows that exercising for 45 to 60 minutes three times a week maintains bone strength. Consider a combination of weight-bearing exercises like lunges or jogging, strength-training exercises like weight lifting or resistance bands, and balance exercises like tai chi or yoga. 

Note: If you’ve already been diagnosed with osteoporosis, talk to your doctor about the safest exercises for you.

Treatment options

People with osteoporosis or worsening osteopenia have several treatment options. One is taking bisphosphonate, a type of drug that helps to reduce bone turnover and enhance bone density, which may be given orally or intravenously. For those unable to take bisphosphonates, denosumab, which is given through an injection, is recommended. Depending on your medical history, your doctor may also consider other medications that contain estrogen or mimic its effects.  

If you have further questions

Want to know more about bone health and menopause? Chat with an Ovia Health coach today. 

Reviewed by the Ovia Health Clinical Team

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