Menopause has a bone to pick with you

The Part No One Mentions - But We Will

Hot flashes get all the noise. Mood swings get blamed for everything from a forgotten password to global instability. Meanwhile your bones are quietly losing density and no one has even told you this was ‘a thing’.

This matters because the menopausal transition is when bone loss speeds up for almost every woman and the effect is measurable long before your sixties. Here are the facts that actually move the needle.

The big numbers you need to know

One. Women can lose up to 20 percent of their bone density in the five to seven years after menopause according to the Bone Health and Osteoporosis Foundation

Two. In the United States about 19.6 percent of women aged fifty and older already have osteoporosis and over half have low bone mass

Three. In Canada nearly two and a half million adults over forty have diagnosed osteoporosis and most of them are women.

Four. At least one in three women over fifty will experience an osteoporosis related fracture in her lifetime.

Five. Postmenopausal women have a significantly higher risk of bone loss and fracture than premenopausal women because of the loss of estrogen.

These numbers paint a clear picture. Osteoporosis is not something that happens in a distant decade. It is something that begins in midlife while most women are busy keeping all the balls in the air while combating ageism in the workplace. No biggie.

Why bone loss speeds up in midlife

Estrogen normally keeps your bone breakdown and bone building in balance. Once estrogen levels fall this balance shifts. The cells that break bone down work harder while the cells that build bone slow down. Over time that gap becomes significant.

This is why a woman can go from normal bone density at forty-eight to osteopenia by fifty-two without a single clue that anything has changed. If you add early menopause, low weight, smoking heavy, alcohol use, steroid treatment, thyroid issues or a family history of hip fractures your risk goes up even faster

Yes - you can control this

The good news is that bone health is not mysterious. It responds well to a handful of consistent habits.

Calcium and vitamin D matter. Most midlife women need around twelve hundred milligrams of calcium each day plus enough vitamin D to maintain healthy levels. Food helps but supplements are often required.

Strength training works. Your bones respond to load. The best results come from a mix of resistance training two to three times a week and regular weight bearing movement on most days. Think brisk walking, hiking, dancing and anything else that makes your muscles pull on your skeleton. Added bonus – dancing usually embarrasses your kids. 2 birds. 1 stone.

Smoking and heavy drinking undermine your bones. It is not judgment. It is biology. Your bone cells notice everything. I’ve tried – and my bones see right through me.

Ask about a bone density scan. Screening at sixty five is the default but not the rule. If you are in your forties or fifties with meaningful risk factors a DXA scan now is entirely appropriate.

Medication is a tool not a failure. If a scan shows osteoporosis or your fracture risk is high there are effective treatments that protect bone and significantly lower fracture risk.

The top five things every woman should know

One. Bone loss accelerates for several years before and after menopause. You can act long before any scan surprises you.

Two. Strength training is one of the most powerful bone preserving tools you have. Your skeleton thrives on challenge. Lift heavy.

Three. Most women with early osteoporosis feel nothing at all. Silence is not a sign of safety.

Four. A baseline bone density scan in midlife can change your long-term health path. Especially if you have risk factors.

Five. Fractures are not inevitable. With nutrition movement and if needed medication you can lower your future risk in a meaningful way.

So the skinny on your bones is this – they won’t tell you when they’re getting weak. They’ll shock you the good old fashioned way – with a fracture or a break. Many women say their doctors don’t talk to them about bone-health until well after there has been demonstrated decline. Let’s not wait for that to happen, shall we?

Like most things in women’s health – we have to push for tests, answers and solutions. We’re here to help with that.