Does Menopause Weaken My Bones?

Nothing hurts. That’s the part that makes bone loss different from every other menopause change. There’s no hot flash, no night sweat and no 3 a.m. wake-up. Your bones thin out without a word, and the first sign can be a fracture from a fall that wouldn’t have mattered at 35.

Why it’s easy to miss

NIAMS² calls osteoporosis a silent disease. It’s a bone disease that develops when bone mineral density and bone mass decrease, and symptoms typically don’t show up until a fracture. The NHS¹ says it’s often only diagnosed when a fall or sudden impact causes a bone to break.

NIAMS² says fractures from minor falls or from everyday stresses like bending, lifting or even coughing are a reason to seek medical evaluation, because they may point to osteoporosis.

What helps

The sources agree on the basics.

Weight-bearing exercise. NIAMS² recommends weight-bearing exercise such as walking. The NHS¹ recommends regular exercise to keep your bones as strong as possible. The Bone Health & Osteoporosis Foundation³ lists four kinds: posture exercises, hip and back strengthening, balance training and functional exercises like climbing stairs or rising from a chair. It says targeted exercises don’t replace walking and other weight-bearing activities, and that balance training can decrease your chance of falling. Our article on menopause weight gain explains why strength training matters for muscle too.

Calcium and vitamin D. NIAMS² recommends a nutritious diet rich in calcium and vitamin D. The NHS¹ lists calcium- and vitamin D-rich foods, and recommends a daily supplement of 10 micrograms of vitamin D. Ask your own clinician what amount suits you.

Lifestyle. The NHS¹ says to give up smoking and reduce alcohol. NIAMS² says to avoid smoking and limit alcohol.

Hormone therapy. The Menopause Society⁴ lists bone protection among the benefits, saying standard-dose therapy helps prevent bone fractures later in life. That’s one factor in the decision, and the full set of risks and benefits is in our article on whether hormone therapy is safe.

The play

Try this: a bone-strength week

Walk on most days, at a pace that gets you breathing harder.

Add one balance move, such as standing on one leg while you brush your teeth with a counter nearby, and one posture move such as a corner stretch, which the Foundation lists.

Look at your plate. Where does your calcium come from, and your vitamin D? If you can’t name them, write down a few foods and bring that to your appointment.

The Bone Health & Osteoporosis Foundation³ says some muscle soreness for a day or two is normal, but pain during exercise is a reason to check with a physical therapist.

When to get checked

NIAMS² says bone density testing exists, and that you should talk with a provider about your own risk factors and which tests make sense. The NHS¹ says to see your GP if you suspect osteoporosis or have risk factors.

The Bone Health & Osteoporosis Foundation³ says people with a recent fracture or low bone density should get professional clearance before starting an exercise program.

Book an appointment if any of these fit:

• You’ve reached menopause and haven’t talked about bone health
• You went through menopause early, or had your ovaries removed
• You’ve broken a bone from a minor fall or an everyday movement
• You smoke, or drink heavily
• You have a family history of fractures or osteoporosis
• You’re starting to exercise after a long break and have low bone density

You can’t feel your bones thinning, but you can walk, lift, balance and eat for them starting tomorrow.