Bone Health During and After Menopause

Learn how menopause affects bone density, plus the nutrients, exercise and habits that support strong bones. Blackmores' guide for post-menopausal women. 

Bone is living tissue that renews itself throughout life. In the years around and after menopause, the pace of that renewal shifts, and bone density becomes more relevant for women and their long-term wellbeing.  

This article looks at how hormonal changes influence bone density, the nutrients most closely linked to bone maintenance, the role of movement, and how to work with a healthcare professional on a bone health routine that fits your life. 

Why bone health matters during and after menopause

Your skeleton supports movement, protects organs, anchors muscles, and stores minerals like calcium. Bones that remain dense and strong contribute to mobility, balance and independence in later life. 

Bone mass builds through childhood and adolescence, reaches its peak in early adulthood, then gradually shifts with age. For women, the pattern of change becomes more pronounced around and after menopause. According to the Australian Institute of Health and Welfare, low bone mineral density accounted for 29% of the fall-related disease burden in Australia in 2018, highlighting the value of paying attention to bone health across the later decades of life. 

How hormonal changes affect bone density

Oestrogen plays an important role in maintaining bone strength. According to Healthy Bones Australia, changes in hormone levels around the time of menopause can affect bone health, and women can lose bone density and strength as a result of these hormonal shifts. 

The 2024 Royal Australian College of General Practitioners and Healthy Bones Australia guideline, published in the Medical Journal of Australia, identifies sex hormone deficiency as a factor in reduced bone mass, noting that early menopause (before the age of 45) is a recognised contributor to lower bone density in women. For women who go through menopause at an earlier age, the guideline suggests earlier conversations with a healthcare professional about bone health. 

What bone density means and why awareness matters

Bone mineral density (BMD) is a measure of how much mineral content, particularly calcium, is packed into a given area of bone. Higher BMD generally reflects stronger, more resilient bone tissue. 

Changes in bone density are usually gradual and do not produce obvious day-to-day symptoms, which is part of why awareness matters during and after menopause. Understanding your own risk profile helps you have informed conversations with your GP and make everyday choices that support long-term bone strength. 

What a bone density test involves

The most common test for measuring BMD is a dual-energy X-ray absorptiometry (DXA) scan. It is a short, non-invasive scan that uses low-dose X-rays to measure bone density at the hip and spine, and sometimes the forearm. 

The result is reported as a T-score, which compares your bone density to that of a healthy young adult. Your GP can help you understand what the result means for you personally. 

Whether a DXA scan is appropriate depends on individual risk factors, family history and age. The Healthy Bones Australia consumer fact sheets provide general information on bone density testing. A GP can advise on whether a scan is right for you based on your circumstances. 

Nutrients that support bone health

Several nutrients contribute to bone maintenance. Calcium, vitamin D and magnesium are among the most consistently discussed in the research on post-menopausal bone health. 

Calcium

Calcium is the main mineral stored in bone tissue and contributes to the maintenance of bone density. According to the NHMRC Nutrient Reference Values, the Recommended Dietary Intake (RDI) for calcium rises to 1,300 mg per day for women aged 51 and over, reflecting the change in calcium needs after menopause. 

The Australian Bureau of Statistics Usual Nutrient Intakes, reported that 90.7% of Australian women aged 50 to 64 years and 87.6% of women aged 65 to 74 years did not meet their calcium requirements from food and beverages alone. This suggests calcium is a common area where post-menopausal women may need to focus dietary attention. 

Vitamin D

Vitamin D helps the body absorb calcium from the digestive tract and plays a role in maintaining bone health. Sunlight exposure on the skin is the primary source of vitamin D for most Australians, with smaller contributions from foods like oily fish and eggs. 

The ABS National Health Measures Survey reported that one in five (20.6%) Australian adults had a vitamin D deficiency. The 2024 RACGP and Healthy Bones Australia guideline recommends that supplements maintain a serum 25-hydroxyvitamin D level above 50 nmol/L, and notes that where oral vitamin D supplements are required, a dose of 800 to 1,000 IU per day is usually sufficient. 

Magnesium

Magnesium is a mineral that contributes to bone formation, muscle function and nervous system regulation. A review published in Nutrients describes magnesium as a cofactor in more than 300 enzymatic reactions in the body. The Nutrient reference values set the RDI at 320 mg per day for women aged 31 and over. 

Protein and other supporting nutrients

Bone tissue is a matrix of protein (mostly collagen) with minerals deposited within it, so adequate protein intake is part of the bone health picture. Vitamin K, zinc and other trace nutrients also contribute to normal bone function. A varied diet across food groups is the most practical way to cover these nutrients. 

Everyday food sources of key bone-supporting nutrients

Whole foods offer the most complete package of bone-supporting nutrients. Practical sources include: 

• Calcium: dairy foods such as milk, yoghurt and cheese, calcium-fortified plant milks, calcium-set tofu, sardines and salmon with edible bones and dark leafy greens such as bok choy and kale.
• Vitamin D: sensible sun exposure per Cancer Council Australia guidance, plus small amounts in oily fish, egg yolks and some fortified foods.
• Magnesium: wholegrains, nuts, seeds, legumes and green leafy vegetables.
• Protein: lean meat, poultry, fish, eggs, tofu, legumes and dairy.

For a broader overview of dietary nutrients across women's life stages, the Blackmores guide to calcium for women offers more detail on food-first approaches. 

Weight-bearing movement and strength training

Bones respond to load. When muscles pull on bone during weight-bearing activity, and when bone is exposed to impact, the body signals bone tissue to remodel and adapt. This is why physical activity is a central part of any bone health routine. 

Australian research supports the value of strength training for bone health after menopause. The LIFTMOR trial followed 101 post-menopausal women with low bone mass over eight months. Half took part in a supervised high-intensity resistance and impact training program twice a week; the other half did lower-intensity exercise at home. By the end of the study, women in the training group had gained bone density at the spine, while the home-based group had lost a small amount. Side effects were rare, and the program was well tolerated under supervision. 

Types of movement that support bone health include: 

• Weight-bearing impact activities: walking, jogging, hiking, stair climbing and dance
• Resistance training with body weight, resistance bands or free weights
• Balance work such as tai chi and standing balance drills, which support fall prevention

The LIFTMOR trial, an eight-month randomised controlled trial, examined supervised high-intensity resistance and impact training in 101 post-menopausal women with low bone mass. Over the study period, the training group showed a 2.9% increase in lumbar spine bone mineral density compared with a 1.2% decrease in the control group performing low-intensity home-based exercise, and modest improvements at the femoral neck. Adverse events were uncommon under supervision. 

If you are new to resistance training or have specific health considerations, an accredited exercise physiologist or physiotherapist can help design a program suited to your circumstances. 

Everyday habits that may affect bone health

Alongside diet and movement, several everyday habits contribute to bone health across the years: 

• Sensible sun exposure: following Cancer Council Australia guidance on balancing vitamin D needs with sun safety
• Smoking: the Healthy Bones Australia menopause fact sheet identifies smoking as a factor associated with lower bone density; quitting smoking supports many aspects of health
• Alcohol moderation: keeping intake within the Australian alcohol guidelines supports overall wellbeing, including bone health
• Maintaining a healthy body weight: very low body weight is a recognised factor for lower bone density
• Sleep and stress management: supporting overall recovery and hormonal balance

Supplement considerations for post-menopausal bone support

Where dietary intake of calcium, vitamin D or magnesium is not consistently meeting recommended levels, supplements may be of assistance. Vitamins and minerals can only be of assistance if dietary intake is inadequate and are best considered alongside food-first strategies rather than as a replacement for a balanced diet. 

The choice of supplement depends on individual needs, current dietary intake and any advice from a healthcare professional. Some women may benefit from a calcium and vitamin D combination; others may look for a broader formulation that reflects the wider changes of post-menopause. 

Blackmores Post Menopause Wellness is a supplement formulated for adult post-menopausal women. Each tablet contains 697 mg of calcium hydrogen phosphate dihydrate (equivalent to 162.5 mg of calcium) 7.5 mcg of colecalciferol (vitamin D3), 259 mg of magnesium citrate (equivalent to 40 mg of magnesium), 100 mg of theanine, and 300 mg of Trigonella foenum-graecum (fenugreek) seed extract dry concentrate (equivalent to 3 g of dry herb). The formulation contributes to the maintenance of bone health, supports vitality, calms the mind, supports a healthy stress response, and may help maintain healthy libido and general health and wellbeing. It is not recommended for pregnant or lactating women. 

If you are taking prescription medication or managing a specific health condition, speak with your GP or pharmacist before starting a new supplement. 

Building a bone health routine after menopause

A workable routine is one you can keep up. A practical starting point: 

• Aim for two to three serves of calcium-rich foods each day
• Include a source of protein at each main meal
• Get regular, sensible sun exposure across the week
• Move most days, with two sessions per week that include resistance or weight-bearing work
• Add balance practice such as tai chi or a short standing balance routine
• Consider whether a supplement fits your circumstances, and check with a healthcare professional if you're unsure

Consistency across the years matters more than perfection in any single week. 

When to talk to your GP about bone density

Some women may benefit from an early conversation about bone health with their GP. Situations that may warrant a discussion include: 

• Early menopause (before age 45)
• A family history of low bone density or fractures
• Long-term use of corticosteroid medication
• Very low body weight
• A previous fracture from a minor fall or bump
• Coeliac disease or other conditions that affect nutrient absorption

Your GP can review your history, discuss whether a bone density scan is appropriate, and help you plan a bone-friendly routine that fits your circumstances. 

Key takeaways for supporting strong bones long term

Bone health becomes a more prominent focus during and after menopause as hormonal changes influence the pace of bone turnover. Close to 90% of Australian women aged 50 to 74 do not meet calcium requirements from food alone. 

Calcium, vitamin D, magnesium and protein all contribute to bone maintenance. Weight-bearing movement and resistance training support bone remodelling and muscle strength, which together contribute to balance and fall prevention. Everyday habits like sensible sun exposure, moderate alcohol intake and not smoking are part of the wider picture. 

Where dietary gaps exist, supplements may be of assistance. A GP can help you understand your personal risk profile and whether a bone density scan is appropriate. 

Frequently asked questions

How does menopause affect bone density? 

During menopause, oestrogen levels drop, and this drop can lead to a decrease in bone density. Oestrogen helps maintain bone strength by slowing the rate of bone breakdown, so when levels fall, bone loss can pick up in the years around and after menopause.  

How much calcium do post-menopausal women need each day? 

The Recommended Dietary Intake for calcium is 1,300 mg per day for women aged 51 and over, an increase from the general adult requirement to reflect the changing calcium needs after menopause. 

Can exercise support bone strength after menopause? 

Yes. Weight-bearing and resistance-based movement contribute to bone remodelling and can support bone density in post-menopausal women. Supervised strength training combined with impact activities has been shown to be particularly beneficial, alongside balance work that supports fall prevention. 

What foods are highest in calcium? 

Good dietary sources include dairy foods, calcium-fortified plant milks, calcium-set tofu, sardines and salmon with edible bones, and dark leafy greens such as bok choy and kale. 

When should I speak with my GP about bone density? 

If you experienced early menopause, have a family history of low bone density, have used long-term corticosteroid medication, have had a fracture from a minor bump, or have other risk factors, a conversation with your GP is a sensible step. Your GP can advise whether a bone density scan is appropriate for you. 

Always read the label and follow the directions for use.

Disclaimer: This article provides general information only and is not intended to diagnose, treat, cure, or prevent any disease. The information presented is not a substitute for professional medical advice. If you have concerns about your health, please consult your GP or healthcare provider for a personalised assessment and recommendations. Supplements should not replace a balanced diet.