Keeping Bones Strong after Menopause
Bones create our physical foundation and influences quality of life after menopause. Keeping bones strong and reducing the risk of osteoporosis is imperative to maintaining movement for enjoyable hobbies and social activities.
Women achieve 95% of bone mass by age 20 and slowly continue to gain bone mass until age 30. An active process of bone resorption and new bone development over time results in more bone being lost than made. Less circulating estrogen after menopause speeds up this process and gradually bone mass lessens. In some women, this can lead to osteoporosis and a greater risk of bone fracture. Maintaining or developing a lifestyle to promote strong bones is imperative during and after the menopause transition.
Key components to improve bone health:
Physical activity – Include forceful resistance and weight-bearing exercises, such as climbing stairs, hiking, dancing, lifting weights, or playing pickleball. Talk with a physical therapist if you need guidance on an exercise program that is right for you.
Calcium – Food sources are best, and calcium can be found in almonds, dairy products (milk, yogurt, cheese), broccoli, kale, brussels sprouts, salmon with bones, and tofu. Talk with your doctor to see if supplements are needed to augment your diet.
Vitamin D – is necessary to absorb calcium. Good sources include sunlight, eggs, mushrooms, fortified milk and cereal, and certain fish (salmon, tuna, whitefish). Talk with your doctor to see if you are getting enough vitamin D and whether supplements are needed.
Potassium – helps metabolize calcium. Good food sources include raisins, prunes, orange and tomato juice, potatoes with skin, acorn squash, spinach, and lima beans.
Protein – Adequate intake protects against bone loss and helps maintain strong muscles and bones. Good sources include dairy products, fish, poultry, legumes, whole grains, nuts, seeds, broccoli, and asparagus.
Avoid smoking and excess drinking – Limit alcohol to no more than one drink per day.
Osteoporosis has no warning signs until a bone breaks.
A DEXA (dual x-ray absorptiometry) scan is a fast and easy way to determine bone density and rate of bone loss. Although it is typically not recommended for women until age 65, that may be too late for women with risk factors. If you are approaching or beyond menopause and have any of the following risk factors, don’t delay speaking with your physician about testing and treatment.
- Family history of osteoporosis
- White or Asian race
- Previous fractures
- Poor nutrition
- Low weight and body mass index
- Estrogen deficiency
- Prolonged amenorrhea or menopause before age 45
- Long-term low caloric intake
- History of falls
- Inadequate physical activity
- Taking medications that reduce bone density
- Cigarette smoking
Women lose up to 20% of their bone mass in the first 5-7 years after menopause. Most older women who fracture a bone were never tested or treated for osteoporosis. Recommended treatment may include menopausal hormone therapy (MHT) or Bisphosphonates. Early treatment combined with the right exercise and a healthy diet, can reduce your risk for osteoporosis and debilitating fractures. Learn if you are at risk for osteoporosis. Start a proactive discussion with your healthcare provider and physical therapist about how to best maintain healthy bones.