Most women worry about gaining weight during menopause, but one of the biggest health changes happening beneath the surface is bone loss.
Around the time of menopause, declining oestrogen accelerates the breakdown of bone, increasing the risk of osteopenia and osteoporosis. Because bone loss occurs silently, many women don’t realise there’s a problem until they experience a fracture.
The good news is that lifestyle plays a major role. Progressive strength training, good nutrition and adequate protein can all help slow bone loss and maintain stronger bones as you age.
What Is Bone Density?
Bone is living tissue that is constantly being renewed.
Throughout life, your body is continuously breaking down old bone and replacing it with new bone through a process known as bone remodelling.
Two specialised cells are responsible for this process:
- Osteoclasts break down old bone.
- Osteoblasts build new bone.
During childhood and early adulthood, bone formation exceeds bone breakdown, allowing bones to grow stronger and denser. Most women reach their peak bone mass by around 30 years of age.
After this point, maintaining bone becomes the priority. During menopause, however, the balance shifts and bone breakdown begins to outpace bone formation.
Why Does Bone Loss Accelerate During Menopause?
Oestrogen plays an essential role in maintaining healthy bones.
It helps maintain the balance between bone resorption (breakdown) and bone formation by influencing both osteoclasts and osteoblasts.
Oestrogen suppresses the activity and lifespan of osteoclasts, the cells responsible for breaking down bone, while also supporting the survival and function of osteoblasts, the cells that build new bone.
During perimenopause and menopause, declining oestrogen levels increase osteoclast activity while reducing the bone-forming activity of osteoblasts. As a result, bone is broken down faster than it can be rebuilt.
Women can lose up to 10–20% of their bone mass during the first 5-7 years after menopause, making this one of the most important times to prioritise bone health.
Risk Factors for Low Bone Density
Some risk factors cannot be changed, while others are strongly influenced by lifestyle.
Non-modifiable risk factors
- Age
- Female sex
- Family history of osteoporosis
- Early menopause
- Previous fractures
- Small body frame
Lifestyle risk factors
- Lack of resistance training
- Low physical activity levels
- Smoking
- Excessive alcohol intake
- Low protein intake
- Inadequate calcium intake
- Vitamin D deficiency
- Long-term restrictive dieting
- Very low body weight
While you can’t change your genetics or age, many of the lifestyle factors that influence bone health are within your control.
1: Strength Training
The most effective way to protect your bones is through progressive strength training.
Bones respond to mechanical loading. When muscles contract against heavy resistance, they place stress on the bones where they attach. This stimulates osteoblasts to build new bone tissue, helping to maintain or even improve bone density over time.
Research consistently shows that progressive strength training using moderate to heavy loads is one of the most effective forms of exercise for preserving bone health after menopause.
To stimulate bone growth, the exercises need to place sufficient load on the skeleton. Simply lifting light weights or using light resistance bands is unlikely to provide the same benefit.
Exercises that load the hips and spine are particularly beneficial. Examples include:
- Squats
- Deadlifts
- Overhead presses
- Lunges
- Step-ups
- Other progressive compound strength exercises
The key is progressive overload – gradually increasing the weight as your strength improves. As your muscles become stronger, the load placed on your bones also increases, encouraging them to adapt and remain strong.
Read more: Why Resistance Training Is Essential for Perimenopausal Women
2: Impact Loading
Higher-impact activities place brief, higher forces through the skeleton and may further stimulate bone growth.
Examples include:
- Jumping
- Skipping
- Hopping
- Racquet sports such as tennis
These exercises are not appropriate for everyone, particularly women with osteoporosis, joint problems or existing injuries.
Always choose exercises that are suitable for your current fitness level and seek professional advice if needed.
3: Protein
When people think about bone health, calcium is usually the first nutrient that comes to mind.
However, bone is not made from calcium alone.
Approximately 50% of bone volume is made up of a collagen-rich protein matrix. This flexible framework gives bone its strength and resilience while providing the scaffold onto which minerals such as calcium and phosphorus are deposited.
While collagen forms the structural framework of bone, it still requires minerals such as calcium and phosphorus to become strong, mineralised bone. This is why both adequate protein and adequate mineral intake are important for bone health.
Adequate protein intake also helps maintain muscle mass.
Stronger muscles improve balance, reduce the risk of falls and increase the mechanical loading that helps maintain healthy bones.
For women over 40, consuming adequate protein every day is an important part of supporting both muscle and bone health.
Read more: The Importance of Protein for Women 40+
4: Vitamin D
Vitamin D helps your body absorb calcium efficiently.
Without adequate vitamin D, even a calcium-rich diet cannot be fully utilised.
Risk factors for vitamin D deficiency include:
- Limited sun exposure
- Spending most of the day indoors
- Winter months
- Darker skin pigmentation
- Consistent use of sun protection
If a deficiency is suspected, your doctor can arrange a simple blood test.
5: Calcium
Calcium is the primary mineral found in bones.
If your dietary calcium intake is too low, your body maintains normal blood calcium levels by drawing calcium from your bones over time. This can contribute to bone loss if it continues over many years.
Australian recommendations suggest women over 50 aim for approximately 1,300 mg of calcium each day.
It’s important to understand that more calcium doesn’t automatically mean stronger bones. Once you’re meeting your daily calcium requirements, consuming additional calcium has not been shown to significantly increase bone density.
6: What to Avoid
Smoking
Smoking accelerates bone loss by reducing bone formation, impairing calcium absorption and lowering oestrogen levels. It is also associated with an increased risk of osteoporosis and fractures.
Excessive Alcohol
Excessive alcohol intake can interfere with bone remodelling by reducing osteoblast activity and increasing the risk of falls and fractures.
Long-Term Restrictive Dieting
Repeated dieting or chronically eating too little can reduce the nutrients and energy needed to maintain healthy bones.
Low energy availability may also reduce hormone production, including oestrogen, further accelerating bone loss over time.
Should You Have a Bone Density Scan?
A bone density scan (DEXA scan) measures bone mineral density and can identify osteopenia or osteoporosis before a fracture occurs.
Speak with your doctor about whether a DEXA scan is appropriate if you:
- Are over 50 years of age.
- Have experienced early menopause.
- Have had a previous low-trauma fracture.
- Have a strong family history of osteoporosis.
- Have been taking long-term corticosteroid medication.
- Have other significant risk factors for osteoporosis.
Early detection allows lifestyle changes and treatment to begin before significant bone loss occurs.
Key Takeaways
✔ Bone loss accelerates during perimenopause and menopause due to declining oestrogen.
✔ Progressive strength training is one of the most effective ways to maintain bone density.
✔ Impact exercise can provide an additional stimulus for bone growth where appropriate.
✔ Adequate protein is essential for both strong muscles and strong bones.
✔ Meet your calcium and vitamin D requirements – but remember that more calcium doesn’t necessarily mean stronger bones.
✔ Avoid smoking, excessive drinking and restrictive diets.
Strong bones allow you to stay active, independent and confident throughout life. The actions you take today can have a lasting impact on your health for decades to come.
Ready to Build Stronger Bones and Muscles?
Inside my 4 Week Starter Challenge, I help women over 40 build strength safely with progressive resistance training, optimise their protein intake and learn practical nutrition strategies designed specifically for women during perimenopause and menopause.
If you’re ready to invest in your long-term health, I’d love to help you get started.
Building strength isn’t just about looking different. It’s about building a body that stays strong, capable and independent for years to come.