How to Boost Bone Health Before and After Menopause

Wednesday, May 11th, 2016, 8:58 pm

Time isn’t your friend when it comes to bone density. But no matter what your age, you can improve your bone health with these tips.

Unlike many other parts of your body, your bones are always in a state of flux, breaking down old bone cells and building new ones. But that process doesn’t stay in perfect balance without your help, explains orthopedic surgeon Lisa Kaye Cannada, MD. Dr. Cannada is an associate professor of orthopedic traumatology at the Saint Louis University School of Medicine in Missouri and a spokeswoman for the American Academy of Orthopaedic Surgeons.

“As you age, the amount of bone turnover is greater than the amount of new bone production,” Cannada says. “As a result, the strength of your bones decreases, putting you at greater risk for fractures.” Your bone density peaks at about age 30, and “it’s all downhill from there,” she adds.

Menopause accelerates the loss. As you approach menopause, your ovaries produce less and less estrogen. And the less estrogen you produce, the more your bone cells break down. This puts you at a greater risk for osteoporosis, or bone thinning, and also for bone fractures.

According to the Arthritis Foundation, women lose about half of their trabecular bone — the spongy tissue that fills your long bones — over a lifetime. Women also lose 30 percent of the denser tissue that covers bones. Most of the loss occurs within the first decade after menopause, but both men and women lose 0.5 percent of bone density every year after age 50.

But you don’t have to take this news lying down. Just the opposite, in fact — you want to get up, get moving, and get with a plan for keeping your bones as strong as possible.

Boost Bone Health: Your Pre-Menopause Plan

The stronger your bones are in your twenties and thirties, the better off you’ll be when you reach the age at which bone density begins to decline. Here’s what you need to do to improve your bone health.

Start young. Make bone health a priority at as young an age as possible, long before menopause. “We are seeing women (and men) in their thirties with problems with their bones because of unhealthy habits they started as teenagers,” Cannada said. Throughout your life, make a point of eating a well-balanced, healthy diet with lots of dairy, fish, fruits, and vegetables and maintain a healthy weight.

Build strong bones. Weight-bearing exercises such as weight lifting and activities you do standing up — like walking, running, jogging, dancing, step aerobics, and tennis — are an excellent way to build bone density. A minimum of 30 minutes of such activity on most days of the week will mean stronger, denser bones.

Protect Bone Health: Your Menopause Plan

It’s never too late to start a bone health action plan with these strategies.

Exercise. If you haven’t started a regular weight-bearing exercise program, it’s not too late, and it becomes even more important as you age. You’ll get the most benefit if you vary the activities — this will make it more interesting, too.

Get calcium. Calcium builds strong bones, and the best source is your diet. Good sources of calcium are dairy products, like low-fat or fat-free milk, and fish such as sardines and salmon. Green leafy vegetables also have calcium, so fill up on kale, collard greens, Brussels sprouts, broccoli, Chinese cabbage, and turnip greens.

Supplement, if needed. Women in their middle years need about 1,000 milligrams of calcium a day. After menopause, the National Osteoporosis Foundationrecommends boosting that number to between 1,500 and 2,000 milligrams a day. If you’re not getting enough calcium from your diet, talk to your doctor about supplements.


Cut back on caffeine. Caffeine causes your body to excrete calcium more quickly. So drink less regular coffee, tea, and caffeinated soft drinks — and avoid high-caffeine energy drinks.

Drink only in moderation. Alcohol can lower your body’s ability to absorb calcium. If you drink, keep it to a glass a day.

Cut down on salt. Like caffeine and alcohol, salty foods can cause you to lose calcium and can speed bone loss. Processed and canned foods tend to be high in salt, so limit your intake. When you do eat these foods, look for low- or no-salt-added brands.

Bone up on vitamin D. You need a good supply of vitamin D to help absorb calcium. The National Osteoporosis Foundation recommends women younger than 50 get 400 to 800 international units (IUs) of vitamin D daily; those 50 and older need 800 to 1,000 IUs. You can also get vitamin D from just a few minutes of sunlight and from some foods, including fish, oysters, and packaged foods that have been fortified, such as cereal. It’s hard to get all the vitamin D you need from your diet, so you may need supplements to maintain your bone health. Many calcium supplements designed for women also contain vitamin D.

Consider osteoporosis drugs. Several medications on the market can help increase your bone strength. One option is hormone replacement therapy (HRT), which replaces the estrogen lost after menopause. However, HRT can have side effects, including an increased risk for endometrial and breast cancer.

Bisphosphonates are another option. These medications slow your bone’s reabsorption rate so you lose less bone. It is unclear, however, whether the benefits of these medications last beyond a few years.


After menopause, you’ll want to discuss the need for these options with your doctor. “Some may be better for you based on your health history than others,” says Cannada. “There are differences in dosing schedules, weekly to annually, and method given — oral versus IV.The most important thing is to start the medications within five years of menopause.”

Cut your chance of falling. Clear your home of clutter so you’re not tripping over shoes left in the hallway or a wire running between your desk and the door. Fix the lighting so you can see your way at night. Strengthening and balance exercises such as tai chi can help you improve your balance. By reducing falls, you reduce your risk for bone fracture.

Bone density starts to decline once you reach your thirties, and menopause accelerates the loss. For a lifetime of good bone health, fight back by eating a healthy diet, maintaining a healthy weight, getting enough calcium and vitamin D in your diet, and staying physically active.

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