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Osteoporosis after menopause: how to protect your bones

About one in five women over 50 has osteoporosis, and most do not know until a bone breaks. The years around menopause are when bone is lost fastest and when prevention pays off most.

Reviewed by Claudia Muresian, health psychologist, fitness coach and healthy nutrition specialist Researched and drafted by the Fit Over 40 editorial team. Last updated November 11, 2026. 6 minute read. How we research and review

The short version

  • Osteoporosis weakens bones and usually causes no symptoms until a fracture.
  • About 1 in 5 women over 50 has it, compared with 1 in 20 men.
  • Women can lose bone quickly for several years around menopause.
  • Women over 65 should have a bone density test, and younger women at higher risk should too.
  • Calcium, vitamin D, protein, weight-bearing exercise, not smoking and limiting alcohol all protect bone.

What osteoporosis is

Osteoporosis is a condition that weakens bones so they break easily, often without warning. About 1 in 5 women over 50 has it, compared with 1 in 20 men. Women can lose bone mass quickly for several years around menopause, and the risk keeps rising with age.1

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Who should be tested

A bone density scan is quick and painless and gives a result called a T-score. Women over 65 should be tested. Younger women at higher risk should be tested too.1 Ask your doctor about earlier testing if you:

  • went through menopause early,
  • have broken a bone after a minor fall,
  • have a parent who broke a hip,
  • smoke, drink heavily or have a low body weight,
  • take steroid medicines long term.

Five ways to protect your bones

1. Get enough calcium

Women need 1,200 mg a day from age 51, and no more than 2,000 mg from all sources.2 Food is the preferred source. See calcium and vitamin D after menopause.

2. Get enough vitamin D and protein

US guidance suggests 800 to 1,000 IU of vitamin D a day for adults over 50.3 Protein is also on the National Institute on Aging's prevention list.1 See how much protein women over 50 need.

3. Load your bones

Do weight-bearing exercise such as walking, dancing or strength training.1 Health guidelines call for muscle-strengthening activity at least twice a week.4 Start with the 10 best exercises for women over 50 or the full-body dumbbell workout.

4. Do not smoke, and limit alcohol

Both are on every official prevention list.1,3

5. Ask about medical options

Hormone therapy has been shown to prevent bone loss and fracture.5 If you already have osteoporosis, medicines can slow bone loss or help rebuild bone. Your doctor will help you choose.1

What about magnesium and other supplements?

Higher magnesium intake is linked to higher bone density, and supplements might help older women, but more research is needed.6 Beans, nuts, seeds, whole grains and leafy greens supply it. For a full review, see menopause supplements: what works.

Prevent falls

Most fractures follow a fall. Strong legs and good balance are protection. From 65, guidelines add balance and strength activity on three or more days a week.4 The lower body and glute workout builds the muscles that keep you steady.

Common questions

What are the first signs of osteoporosis?

Often there are none. Many people find out only after a break, most often in the hip, spine or wrist. That is why screening matters.1

What is the best exercise for osteoporosis prevention?

Weight-bearing exercise such as walking, dancing and strength training. If you already have osteoporosis or have had a fracture, ask your doctor or a physical therapist which exercises are safe for you.1

Does hormone therapy help bones?

Yes. Hormone therapy has been shown to prevent bone loss and fracture. Whether it suits you depends on your age, time since menopause and health history.5

References

  1. National Institute on Aging. Osteoporosis. https://www.nia.nih.gov/health/osteoporosis/osteoporosis
  2. National Institutes of Health, Office of Dietary Supplements. Calcium: fact sheet for consumers. https://ods.od.nih.gov/factsheets/Calcium-Consumer/
  3. MedlinePlus, US National Library of Medicine. Calcium, vitamin D, and your bones. https://medlineplus.gov/ency/patientinstructions/000490.htm
  4. World Health Organization. Physical activity: fact sheet. https://www.who.int/news-room/fact-sheets/detail/physical-activity
  5. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767-794. https://pubmed.ncbi.nlm.nih.gov/35797481/
  6. National Institutes of Health, Office of Dietary Supplements. Magnesium: fact sheet for consumers. https://ods.od.nih.gov/factsheets/Magnesium-Consumer/
About this article

Every health claim above links to its source. Before publication the article was read and approved by Claudia Muresian, health psychologist, fitness coach and healthy nutrition specialist. It is general information and cannot take your personal history into account, so use it to prepare for a conversation with your own clinician.

Spotted an error? Tell us and we will check it.

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