What to Know About Bone Density and Menopause

Menopause marks a major milestone in a woman’s life. During this phase, our bodies go through changes that affect everything from temperature control to emotional balance. Although hot flashes and mood shifts often grab our attention, bone health is an important issue that sometimes gets missed. Many of us are surprised to learn that menopause is a time when our bones can weaken at a much faster pace, which makes paying attention to bone density especially important.

When we look at the science, menopause ramps up bone loss because of changes in hormone levels. Estrogen usually shields our bones by helping to build and protect their structure. Once estrogen levels begin to fall, bone breakdown speeds up. Experts estimate that up to 20 percent of bone loss may happen during the first few years after menopause begins. That’s a huge risk for bone fractures.

Almost half of postmenopausal women will experience an osteoporosis-related fracture during their lifetime.

In this blog, we explain what to know about bone density and menopause, including what triggers this change, who faces the highest risks and the best ways to protect our bones.

We speak to Bhushan Shrikhande, M.D., an endocrinologist with INTEGRIS Health Southwest Medical Center, to learn more. 

“Osteoporosis is a systemic condition in which the bones become structurally weak and are more likely to fracture,” Shrikhande says. “If you have osteoporosis, several treatments are available to stabilize or improve bone density. Talk to your doctor about what your options might be.”

Why bone health matters during menopause

Key points: Menopause is a turning point for bone health. Sharp drops in estrogen levels lead to rapid bone loss and increase the risk of fractures.

Up to 20 percent of bone density may be lost in the first several years after menopause.

• About one in two postmenopausal women will have a fracture related to osteoporosis during their life.
• Fractures linked to bone thinning often happen without any warning symptoms.

Strong bones support our daily life and independence. 

• When bone density falls too low, small slips or falls can cause serious injuries.
• If we can catch these changes early, we can make choices to slow down bone loss and strengthen our bones.

The connection between menopause and bone density

The basics: Lower estrogen levels are the biggest reason for bone loss during and after menopause.

• Osteoporosis usually has no obvious symptoms until a bone breaks.
• It is recommended to screen for osteoporosis in women 65 years and older and for women under 65 who have gone through menopause and have risk factors (such as past fracture, certain medical conditions or medications, or active cigarette or alcohol use)

Bone is a living tissue that is always rebuilding. 

• Estrogen manages the balance between building and breaking down bone.
• With menopause, less estrogen tips the scale and causes bone to break down faster than it rebuilds.
• That’s what makes this stage of life so critical for bone health choices.

Risk factors for bone loss

What to know: Not everyone’s bone health is affected in the same way. The risk for osteoporosis and bone fractures depends on genetics, lifestyle and health history.
Having a family member with osteoporosis increases our chances of bone loss.

• Habits like smoking, drinking alcohol and following a diet low in calcium or vitamin D raise risk.
• Health conditions such as early menopause, hyperthyroidism or using steroids for a long time also play a role.

Some risk factors cannot be changed, like ethnicity and genetics.

• However, we can improve bone strength by focusing on healthier habits and watching out for conditions that might speed up bone loss.

Prevention strategies

How to protect your bones: Early action is the best defense. Start bone-friendly habits as soon as possible and keep them going into menopause and beyond.

• Get enough calcium each day (1,000 to 1,200 milligrams for adults) from food or supplements.
• Make sure your vitamin D intake is between 600 and 800 international units (IU) a day to help your body absorb calcium.
• Engage in weight-bearing activities like walking, jogging or dancing to keep bones strong.
• Stop smoking and limit alcohol since both can weaken bone tissue.

Having healthy bones is possible at any age. 

• Start with a calcium-rich diet, consistent physical activity and regular health care visits to monitor your bone health.

Treatment options

• Medications called bisphosphonates and denosumab work to slow bone breakdown.
• Some medicines, like teriparatide or abaloparatide, help the body produce new bone.
• Hormone replacement therapy (HRT) with estrogen is not recommended solely for the prevention or treatment of osteoporosis in postmenopausal women. However, women who choose to take estrogen to relieve symptoms of menopause will also have the benefit of a reduction in risk of bone loss and fracture and do not need additional treatment to prevent bone loss.
• Certain medications, known as selective estrogen receptor modulators (SERMs), produce some estrogen-like effects in the bone. These medications, which include raloxifene (brand name: Evista) and tamoxifen, provide protection against postmenopausal bone loss although they are less effective in preventing bone loss than bisphosphonates or estrogen.
• Calcium and vitamin D supplements support bone health, especially when combined with other treatments.

Working closely with your health care provider can help you tailor a plan that fits your needs. 

Lifestyle changes for long-term bone health

Why it matters: Simple shifts in how we eat, move and spend our time can help keep bones healthy for the long run.

Include strength and balance exercises, such as light weights and yoga, to help prevent falls and fractures. Balance training exercises are also encouraged to help prevent falls as you age. 

• Add foods to your meals that are high in calcium, such as milk, cheese, yogurt and leafy greens.
• Get some time outdoors because sunlight helps the body naturally produce vitamin D.
• Try to maintain a healthy weight 

Even small steps like switching to fortified breakfast foods or adding an afternoon walk can have long-lasting effects.

Taking charge of your bone health

What you can do: Being proactive now will help maintain bone strength for years to come.

Ask your health care provider about when it would be the right time to get a bone density test after menopause.

• Talk about medication, dietary and exercise options to fit your health and personal lifestyle.
• Start with small, manageable changes you can stick to for lasting benefit.

When you care for your bones, you can keep moving, enjoy activities and support your independence as you age. 

• Taking these steps today makes a real impact on our health tomorrow.

Take the first step toward better bone health 

Bone health plays a crucial role in maintaining your overall mobility and independence, especially as you age. 

• Weak or brittle bones can result in fractures and other complications that impact your quality of life.
• By addressing your bone health early through proper nutrition, exercise and medical advice, you can significantly reduce the chance of suffering from fractures later in life.
• Consulting a specialist can provide you with personalized strategies to keep your bones strong and healthy for years to come. 

Next steps: At INTEGRIS Health, our team is ready to guide you toward better bone health. Take the first step by connecting with a trusted expert. Find a doctor near you to explore how you can build and protect your bone health starting today. 

• We offer bone density scans and blood tests to check for conditions that may contribute to osteoporosis.

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