How does the menopause affect your bone health?

Emma Mitchell
Physiotherapist at Bupa UK
18 May 2023
Next review due May 2026

After the menopause, your risk for certain health conditions increases. These include heart disease and osteoporosis. But there is lots you can do to reduce these risks, so you can enter life post-menopause, healthy and strong. Here, I’ll explore how the menopause can affect your bone health, and what you can do to help.

A lady working out with dumbbells at home

Why does the menopause affect your bone health?

Oestrogen is a key hormone in maintaining your bone health. During the perimenopause, your oestrogen levels will rise and fall, but at the end of the menopause, your oestrogen levels decline for good. Oestrogen is responsible for maintaining your bone density and bone strength. When you have less dense bones, they become weaker.

Having an early menopause (before the age of 40) can increase these risks. And if you’ve had your ovaries removed this can further raise your chance of bone issues too.

Sometimes additional risk factors can also affect bone health at this time of life. These include a family history of osteoporosis, or regularly taking medications such as steroids for asthma. These medications can also reduce your bone density and strength.

What bone issues can the menopause cause?

When your bones are weaker, you’re at an increased risk of a condition called osteoporosis. This condition puts you at a higher risk of fractures and breaks.

Usually, the first time you are diagnosed with osteoporosis is when you’ve had a bone break after the menopause. But sometimes weakened bones in the spine can cause your posture to change too. This can mean your back appears more rounded and you might find yourself losing height.

A doctor may be able to discover if you’re starting to develop the early signs of osteoporosis. For example, if you have a bone density scan, your doctor can sometimes see signs of reduced bone density. This is known as osteopenia and it’s the first stage of osteoporosis.

If your doctor finds osteopenia at this early stage its sometimes possible to prevent it from developing into osteoporosis. This can involve making lifestyle changes and taking bone strengthening medications.

How can you look after your bone health after the menopause?

There are a number of strategies to help your bones stay strong as you age. They include the following.


Your doctor might discuss if it would be suitable for you to take HRT (hormone replacement therapy). This can help to increase your levels of oestrogen which can reduce some of the key health risks for post-menopausal women, including osteoporosis.


There are also some key lifestyle changes which may help too. Starting a regular and consistent routine of strength-based training is very important at this stage of life. Strength-based training can help to counteract the loss of bone strength and density you experience after menopause.

Some exercises you could try include:

  • yoga or Pilates
  • bodyweight movements such as squats and planks
  • resistance band exercises
  • water aerobics
  • walking
  • weightlifting
  • using weighted machines at the gym

Even things such as standing up from your chair without using your hands and carrying your shopping home can help to build bone strength.


Eating a healthy diet is important at any age. But as you finish the menopause it’s very important to eat a diet which will help to keep your bones strong. This means getting plenty of protein because it contains the building blocks needed for strong muscles. And strong muscles can also help to support your bones too.

You also need to make sure that you’re getting a good amount of calcium in your diet. Calcium helps you to maintain bone density, so it’s a good idea to consume dairy products regularly. If you have a plant-based diet, then check your dairy free milks to see if they are fortified with calcium too.

Another mineral which is essential for bone health is Vitamin D. You can find Vitamin D in oily fish and egg yolks, but the best source is the sun. The UK government recommends that everybody supplements with Vitamin D from October to March. This is because there’s not enough sunlight during these months for you to get your Vitamin D requirements.

Entering the menopause can be a difficult time, but it can help to know that eating well and moving more can help to reduce your health risks. And while HRT had a bad reputation in the past, many doctors are now prescribing it to women who would benefit. So, you could speak to your doctor to find out if would be beneficial for you.

If you’re experiencing menopause symptoms, you don’t have to face them alone. With a Bupa Menopause Plan, you can discuss symptoms with a specially trained GP, get a personalised care plan based around your needs with access to 24/7 support via Anytime HealthLine.

Emma Mitchell
Emma Mitchell
Physiotherapist at Bupa UK



Julia Ebbens, Health Content Editor at Bupa UK

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    • Personal correspondence with Emma Mitchell, Bupa physiotherapist, May 2023
    • Overview of osteoporosis. National institute of arthritis, musculoskeletal and skin diseases. www.niams.nih, accessed 15 May 2023
    • Osteoporosis. NHS., accessed 15 May 2023
    • Holubiac I, Leuciluc F, Craciun D et al. Effect of Strength Training Protocol on Bone Mineral Density for Postmenopausal Women with Osteopenia/Osteoporosis Assessed by Dual-Energy X-ray Absorptiometry (DEXA). Sensors (Basel). 2022; 22(5): 1904. doi: 10.3390/s22051904
    • Bhatnagar A et Kekatpure A. Postmenopausal Osteoporosis: A Literature Review. Cureus. 2022; 14(9): e29367. doi: 10.7759/cureus.29367
    • Vitamin D. British association of dietitians., accessed 15 May 2023
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