When menopause hits, your risk of bone fractures goes up. Here’s how to protect your skeleton (and deal with other menopause symptoms, too).
Some hallmark signs of menopause, like hot flashes, weight gain and hair loss, garner a lot of attention. However, there’s a less obvious change women can’t afford to ignore during and after menopause: declining bone density.
Menopause, which usually starts in a woman’s late 40s or early 50s and lasts about seven years, is marked by decreases in the hormone estrogen. “Estrogen helps you build bones,” says , an obstetrician/gynecologist at . “When your estrogen levels start fluctuating, you don’t maintain as much bone mass.”
Here's how bone mass changes as you age:
Children to young adults
Children and young adults are building toward peak bone mass — the strongest bones they’ll ever have. Most people reach peak bone mass between the ages of 25 and 30.
“To some extent, genetics determines the peak, but lifestyle influences, such as diet and exercise, are also factors,” , a sports medicine specialist with in State College.
40s
After age 40, bone mass slowly decreases. Taking 1,000 milligrams of calcium and 600 International Units (IU) of vitamin D per day can help preserve your bones. Weight-bearing exercise, such as running and brisk walking, and resistance training (muscle-strengthening) are important to maintain muscle and bone strength and prevent falls as you prepare for (or enter) menopause.
“Strength training puts stress on your bones and leads to more bone remodeling, which increases bone density,” Bashua says.
50s
Women who are over 50, entering menopause or have gone through menopause should increase their calcium intake to 1,200 milligrams per day. Ask your doctor about estrogen replacement therapy for menopause, too. This medication can help prevent osteoporosis and ease irritating menopause symptoms like hot flashes.
“While menopause is sort of inevitable, it doesn't have to change your life drastically,” Bashua says. ”You can get help for your symptoms. You don't have to suffer through it.”
Some women, such as cancer survivors, can’t take estrogen replacement therapy. However, alternative medications, such as fenizolatant, can ease menopausal symptoms. While these medications don’t help you build bones, they can help you feel better so you can keep up healthy diet and exercise habits.
After age 50, the daily recommended calcium intake for men remains 1,000 milligrams per day.
60s
All women 65 or older should get a bone density study. Women 60 to 64 years old who have an increased fracture risk, such as a history of fractures or a family history of osteoporosis, should also get the tests.
“If the bone density study shows osteoporosis, it may be reasonable to start taking a medication called a bisphosphonate, which you can get in a variety of forms,” Bosha said. “Some are pills taken on a weekly or monthly basis and other varieties can be taken intravenously.”
Other medications to improve bone density include calcitonin, which you can administer in a nasal spray; parathyroid hormone, which is taken by injection; or a category of medications called selective estrogen receptor modulators.
Age 70 and beyond
After age 70, both men and women should take 1,200 milligrams of calcium per day and 800 IU of vitamin D per day. Men become much more likely to have lower bone density and may suffer fractures. Some men may want to consider getting a bone density study.
“For people of this age, avoiding falls is crucial,” Bosha said. “Maintaining balance and muscle strength through exercise and maintaining strong bones through adequate calcium and vitamin D intake can help decrease the risk of severe fractures from falls.”
The is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.
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