Menopause and Bone Loss: Why Your Daily Routine Might Not Be Protecting You

When it comes to the benefits of exercise during menopause, the message is loud and clear— physical activity works wonders to provide support for mental wellness, physical health, and weight management.¹

But if your goal is to preserve bone mass, emerging science reveals not all exercises are created equal. Here, Dr. Alyssa Dweck, Chief Medical Officer at Bonafide, offers insight into this new research and on all-things-menopause bone loss, including the science behind hormonal and age-related bone changes, as well as some of the more effective exercises to prioritize for bone strength.

The Relationship Between Menopause and Bone Density

First, let’s take a look at the relationship between menopause and bone loss. 

Due to the volatile fluctuations and eventual decline of the hormone estrogen during the menopause transition – a hormone known to protect bone health – it’s been found that as much as 20% of bone loss occurs within the first five years of menopause.^2,3 

So, what’s the big deal about bone loss, exactly? It has a lot to do with the fact that even gradual bone loss can be a slippery slope into life-altering diseases, like osteoporosis.⁴

It’s been estimated that around 50% postmenopausal women will have osteoporosis, a disease that weakens bones and reduces bone density.⁵ The results of this condition can be life altering—with a heightened risk of fractures and falls, women diagnosed with osteoporosis are more likely to be vulnerable to pain and experience decreased mobility as they age.⁶

Menopause Bone Loss Risk Factors

According to Dr. Dweck, the risk for bone loss is “multifactorial,” suggesting more than one variable is at play in women losing bone mass and strength. She adds the following may increase a woman’s risks for bone loss and/or osteoporosis:

• Family history of osteoporosis
• Caucasian or Asian ethnicity
• Diminished lifetime exposure to estrogen
• Smoking
• Menopause

Can I Slow Menopause Bone Loss?

Fortunately, Dr. Dweck confirms there are ways to slow down bone loss during menopause– but common daily routines like walking, yoga, or dietary supplements may not be enough to help. 

So, what else can you do?

A recent study echoes Dr. Dweck’s thoughts. The research study observed the bone health of nearly 200 women from perimenopause to postmenopause while measuring the number and intensity of individual impacts during their everyday life – note this study did not measure effects of high-intensity impacts.⁷  Results showed bone properties in areas of the femoral neck, femoral shaft, and tibial shaft weakened due to normal daily impacts during the follow-up period suggesting that the regimen of the average person, without the inclusion of specific exercise, likely isn’t enough to slow menopause-related bone loss.⁸ 

The good news? There are effective ways to boost bone health during a time when our bones are naturally breaking down at a faster rate than the body can grow new tissue.⁹ 

Let’s dive in.

Tips for Supporting Bone Health During Menopause

Looking for tips on improving your bone density during menopause? Dr. Dweck says you should consider focusing more on specific, targeted exercises and try fine-tuning your diet to prioritize your bone health. Also, it may be more beneficial if you don’t wait until perimenopause hits to get started on supporting your bone health– consider incorporating some of these ideas into your technique proactively. 

“Weight bearing exercise as well as adequate calcium and vitamin D intake are suggested for optimal bone health,” says Dr. Dweck. “I also recommend addressing modifiable risk factors, such as smoking, as young as women are able in order to optimize their bone health.”

Try Bone-Building Exercises

While low impact activities, like walking or yoga, might not help to prevent bone loss, resistance training and strength training appear more promising, according to scientific research. One 2015 study highlighted that consistent resistance training helped women–particularly those in postmenopause–to improve bone mineral density over a six-month period.^10,11 Other, newer studies have found that low-load, high repetition resistance training lessened bone loss in the spine and femur of study participants, while strength training promoted bone formation and strength.^12,13 

Not sure where to start? After consulting and clearing a new exercise routine with your healthcare provider, consider trying out some foundational strength training exercises that work to emphasize the movements you make every day. 

Common strength training exercises can include:¹⁴

• Squats
• Deadlifts
• Glute Bridges
• Overhead Press
• Push-Ups
• Bent-Over Row
• Lunges

You can begin strength training at home or in a gym. Beginners can focus more on adjusting to their movements with only body weight, and then move on to incorporate resistance straps, free weights, weight machines, or cable training.¹⁵

Consume Foods Rich in Calcium and Vitamin D.

Calcium is a mineral that accounts for a large component of our bone’s building blocks. Unfortunately, bones can’t make calcium– we need to obtain it from our diets in order to build strong bones and teeth, and to keep our muscles, heart, and nerves working properly.¹⁶ It’s recommended that adult women younger than 50, consume 1,000 mg of calcium per day, while women over 50 should aim for 1,200 mg.¹⁷  While it’s preferred that calcium comes from dietary sources, supplemental calcium is also available to fill any gaps. 

You can also consider incorporating these foods, which are high in calcium^{18,19, 20}

• Fish, like salmon and tuna (especially canned salmon and sardines, which includes small, edible bones)
• Leafy, green vegetables
• Dairy products like yogurt, kefir, and milk
• Calcium-fortified fruit juices
• Calcium-fortified plant-based milks (almond, rice, etc.)
• Dried figs or prunes

It’s important to note that vitamin D helps the body absorb and use calcium.²¹ You can boost your vitamin D levels from safe sun exposure and through diet and supplements.²²³ Some foods rich in vitamin D, like certain types of fish, can also overlap as calcium rich foods, offering a dual benefit in your diet. 

Foods you can look to that are high in vitamin D^23,

• Fish like trout, salmon, tuna, or sardines
• Fortified dairy or soy products (milk, yogurt, kefir)
• Mushrooms
• Fortified fruit juices and plant-based milks
• Egg yolks

Consider Alternative Treatments for Bone Loss, Like HRT

For those struggling with bone loss during menopause, Dr. Dweck advises that treatments like menopausal hormone replacement therapy may help slow the progression. 

“Menopausal hormone therapy (MHT) is not just for hot flashes; it is also indicated for prevention of bone loss and related fractures,” she says. “Some find this dual purpose extremely appealing.”

While HRT proves helpful for many women, it’s generally not recommended for those with a history of breast cancer, blood clots, or heart disease, among other illnesses.²⁶ A healthcare provider who knows your medical history and status may be able to determine if HRT is the right management option for you.

It’s Never Too Late to Prioritize Your Health

While menopausal women are vulnerable to hormonal bone loss, you can try targeted, strength training exercises and fine-tuning your diet to slow the progression and potentially even improve bone mass. But remember, it’s always important to speak with your healthcare provider first  about ways to prioritize your bone health that are safe and appropriate for you. 

Menopause Bone Loss | Menopause and Bone Density | Bonafide

Resources:

1. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389
2. https://health.clevelandclinic.org/osteoporosis-and-menopause
3. https://pmc.ncbi.nlm.nih.gov/articles/PMC8836058/
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC8836058/
5. https://my.clevelandclinic.org/health/diseases/4443-osteoporosis
6. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
7. https://medicalxpress.com/news/2025-03-everyday-physical-bone-loss-menopause.html#google_vignette
8. https://journals.lww.com/acsm-msse/fulltext/2025/05000/associations_of_habitual_skeletal_loading_with.7.aspx
9. https://themenopausecharity.org/2021/10/21/lifestyle-for-healthy-bones/
10. https://www.orthopt.org/blog/the-role-of-strength-training-in-preventing-osteoporosis-functional-exercises-and-evidence-based-benefits
11. https://pubmed.ncbi.nlm.nih.gov/25772806/
12. https://pubmed.ncbi.nlm.nih.gov/22376192/
13. https://pubmed.ncbi.nlm.nih.gov/35271050/
14. https://www.womenshealthmag.com/fitness/g27393163/strength-training-exercises/
15. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670
16. https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health
17. https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health
18. https://www.dietaryguidelines.gov/food-sources-calcium
19. https://www.health.harvard.edu/womens-health/surprising-foods-that-boost-bone-health
20. https://themenopausecharity.org/2021/10/21/lifestyle-for-healthy-bones/
21. https://themenopausecharity.org/2021/10/21/lifestyle-for-healthy-bones/
22. https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials/food-sources-select-nutrients/food-sources-vitamin-d
23. https://www.healthline.com/nutrition/9-foods-high-in-vitamin-d
24. https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/