As women approach menopause, much of the conversation focuses on hot flashes, sleep changes, and shifting hormones—but another important change can be happening quietly: women can begin losing bone density.
Estrogen plays an important role in maintaining bone strength. As estrogen levels decline during the menopause transition and after menopause, bone breakdown can accelerate. Over time, this can increase the risk of osteopenia and osteoporosis.
Osteopenia vs. Osteoporosis
Think of bone density as a spectrum.
Osteopenia means bone mineral density is lower than expected, but not low enough to meet the definition of osteoporosis. It can serve as an early warning sign and an opportunity for women to focus on protecting bone health.
Osteoporosis is more advanced loss of bone strength and is associated with an increased risk of fractures—particularly of the hip, spine, and wrist.
🥛🥬 Calcium: It’s Not Just About Milk
Calcium is one of the essential building blocks of healthy bones.
Milk, yogurt, and cheese are well-known sources of calcium and can also provide valuable protein. But dairy isn’t the only way for women to get calcium.
Several vegetables and plant foods can contribute calcium to the diet, including:
• Collard greens
• Kale
• Bok choy
• Broccoli
• Turnip greens
• Mustard greens
• Okra
• Watercress
• Edamame
• Calcium-set tofu
Other options include calcium-fortified plant milks and foods such as canned sardines or salmon with edible bones.
One interesting point: spinach contains calcium, but the body doesn’t absorb much of it because spinach is high in oxalates, which bind calcium. Lower-oxalate greens such as kale, bok choy, broccoli, and collard greens can provide calcium that is more readily absorbed.
Vitamin D is important too because it helps the body absorb calcium.
The goal isn’t simply to consume as much calcium as possible. Women should aim for an appropriate amount—preferably through a varied, nutrient-rich diet—and discuss supplementation with a healthcare professional when needed.
Use It or Lose It!
🏋️♀️ Bones follow the “use it or lose it” principle.
Bone is living tissue. It responds to the demands placed on it.
Weight-bearing activities such as walking, hiking, stair climbing, dancing, and jogging—as appropriate for an individual’s fitness level—place healthy stress on the skeleton.
Resistance training is especially important. When muscles pull against bones during strength training, the skeleton receives a signal to adapt and maintain strength.
Think: USE IT OR LOSE IT.
Exercise also helps women maintain muscle mass and improve balance, which can reduce the risk of falls and fractures as they age.
🔎 How can women know what’s happening inside their bones?
That’s where a DEXA (DXA) scan comes in.
A DEXA scan is a quick, noninvasive test that uses very low-dose X-rays to measure bone mineral density, usually at the hip and spine.
During the test, a woman lies on a padded table while a scanner passes over the body. There are no injections, and the test is generally painless.
The results help healthcare professionals assess whether bone density is in the expected range or consistent with osteopenia or osteoporosis. Results are interpreted alongside factors such as age, menopause status, medical history, medications, previous fractures, and overall fracture risk.
Routine osteoporosis screening is generally recommended for women starting at age 65, while younger postmenopausal women may benefit from earlier screening when they have increased fracture risk or other risk factors. Women should talk with their healthcare professional about when screening is appropriate for them.
❤️ Menopause doesn’t mean osteoporosis is inevitable.
The years leading into and following menopause are an important time for women to become proactive about bone health:
🥛 Get adequate calcium
🥬 Eat calcium-rich vegetables and greens
☀️ Maintain adequate vitamin D
🥚 Get enough protein
🏋️♀️ Incorporate resistance training
🚶♀️ Stay active with weight-bearing exercise
🚭 Avoid smoking
🍷 Moderate alcohol
🩺 Know individual risk factors and discuss DEXA screening when appropriate
A lot of attention is given to preparing women for hot flashes and other symptoms of menopause.
Women should also be preparing their bones for the decades that come after it. 🦴💪
Educational information only and not a substitute for individualized medical advice.
“Menopause is not the end of vitality—it is an invitation to care for yourself with greater intention. Nourish your bones, strengthen your body, protect your health, and step confidently into the years ahead.” 🌿🦴
