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From the mid-30s onwards, bone breakdown overtakes bone production. It is part of the normal ageing process that bones lose their mineral (calcium) and protein (collagen) content. As midlife continues, and women experience menopause, the process of bone loss is further accelerated.

Menopause is when a woman stops menstruating and is a natural part of life. It usually occurs between 45-55 years of age, with the average age in Australia being 51 years. However, some women can experience menopause at an earlier age. During menopause the ovaries stop producing the hormones oestrogen and progestin. It is the lack of oestrogen that has significant effects on your bones. In the years immediately following menopause, there is period of rapid bone loss that can last for 4-8 years. Most bone loss occurs in the first three years after menopause, then the rate of bone loss slows. It is more common for women to develop osteoporosis after menopause. Osteoporosis is a condition in which a loss of bone mass and strength makes bones more fragile and more likely to break. 

Bone production

Bone is living tissue made up of specialised bone cells and, like the rest of the body, it is constantly being broken down and renewed. People who were able to achieve a high peak bone mass earlier in life have a greater capacity to withstand the effects of age- related bone loss. A low peak bone mass will increase the risk of developing osteoporosis in the long term. Although your bone mass may have reached its peak, sustaining bone density and strength requires continued adequate vitamin D levels, sufficient calcium intake and physical activity.

Maintaining healthy bones

Physical activity

Like muscles, bones need physical activity to gain strength. The types of physical activities most beneficial to bones include weight-bearing and strength training exercises. The term ‘weight-bearing’ refers to exercises performed on your feet, working against the force of your own body weight. Examples include walking, running, jumping, tennis and dancing. ‘Strength training’ includes weight lifting and other resistive exercises.

Calcium

Midlife is also a time when your gastrointestinal system becomes less efficient at absorbing calcium from food. Your kidneys also become less efficient in conserving calcium, creating a state of potential calcium loss in the blood. Your body compensates by drawing calcium out of your bones. So, not only do the bones become weaker because of oestrogen deficiency at menopause, they also lose more calcium. After menopause women need to have about 1000mg of calcium daily – Equivalent to 3-4 serves of dairy products per day. If you find this intake difficult to achieve, it may be necessary to take calcium supplements. 

Vitamin D

Vitamin D is also an important requirement for maintaining healthy bones, as it assists in depositing calcium in bone. The major source of vitamin D is manufacture in the skin upon exposure to sunlight. Only 10-15 minutes of sunlight are needed each day to provide adequate levels of vitamin D. Some women may require vitamin D supplements. This is best considered after your vitamin D levels have been measured by your doctor. 

Hormones

Some women may consider using short term hormone therapy after menopause to treat symptoms such as hot flushes. It is best to discuss this option with your doctor so that an informed decision can be made.

Avoid smoking

Women who smoke lose bone strength faster than women who do not smoke. Furthermore, smoking is a strong risk factor for fracture.

Further resources 

Content updated 3 August 2011