Osteoporosis

Why Menopause Is a Critical Window for Protecting Your Bones

Written by: Dr. Madeleine Clark, ND MSCP

Osteoporosis is often thought of as a condition of old age—but the groundwork for lifelong bone strength is laid much earlier. For women, the menopause transition is a major turning point. It’s when bone loss accelerates most rapidly, making it a key time for screening and prevention.

What Is Osteoporosis?

Osteoporosis is a skeletal disorder marked by reduced bone strength, increasing the risk of fragility fractures, particularly in the hip and spine.

These fractures are more than just a nuisance:

  • Hip fractures increase mortality risk 5–8x in the first 3 months

  • One year later, there’s still a 20% excess risk of death (this risk follows you for ten years!)

  • 50% of women lose mobility long term

  • 25% require long-term care

  • Many experience fear of falling, leading to reduced physical activity and social isolation

Why Bone Loss Speeds Up in Menopause

Bone is constantly being remodeled:

  • Osteoclasts remove old bone

  • Osteoblasts lay down new bone

In healthy younger individuals, this cycle stays in balance. But with estrogen deficiency, bone breakdown starts to outpace bone formation, weakening the bone structure.

When does this occur?

Bone loss begins 1–3 years before menopause and continues for 5–10 years after the transition. Women lose about 2% of bone per year during this time. By age 80, the average woman has lost up to 30% of her peak bone mass that she originally started with.

Who Should Be Screened?

A bone mineral density test (DEXA scan) is the standard screening tool.

In Canada, screening is recommended for:

  • Women 65+

  • Postmenopausal women under 65 with risk factors

Risk Factors for Osteoporosis

You may be at increased risk if you have any of the following:

  • Previous low-trauma fracture

  • Early menopause (before 45)

  • Long-term corticosteroid use

  • Low BMI or body weight

  • Family history of hip fracture or osteoporosis

  • Smoking

  • Excessive alcohol intake: More than 3 drinks/day is associated with a 38% increased risk of osteoporosis and a 68% increased risk of hip fracture

  • Inactivity

  • Low calcium or vitamin D intake

  • Chronic conditions like celiac disease, rheumatoid arthritis, or thyroid disorders

Why It’s Not Just About Calcium

Bone health isn’t just about supplements. Long-term bone strength is supported by:

  • Resistance and weight-bearing movement

  • Nutrition tailored to bone-building nutrients

  • Hormone balance (including HRT, where appropriate)

  • Fall prevention strategies

  • Addressing inflammation and chronic stress

The Bottom Line

Your midlife years matter. Menopause isn’t just a time of hormonal change—it’s a critical window to take action. Supporting your bone health now helps preserve your mobility, independence, and strength for years to come.

Let’s Protect Your Bones—Together

Book a visit to assess your bone health risk and build a personalized plan. We'll look at your hormones, movement, nutrition, screening qualifications, and long-term health strategy to keep you strong, steady, and thriving.

hormonal health, menopause, perimenopause, ExerciseMadeleine Clark