Bone health deserves attention after menopause. Falling estrogen levels can speed up bone loss, often without symptoms. A practical prevention plan includes screening at the right time, eating and moving in ways that support bone, reducing fall risks, and discussing treatment if your fracture risk is high.

What changes after menopause

Estrogen helps keep bone breakdown and rebuilding in balance. When it declines, breakdown can outpace rebuilding, and bone density can fall faster than in earlier decades. Because bone loss is usually silent, the first sign may be a broken bone.

Risk is higher with a small body frame, a family history of osteoporosis or hip fracture, early menopause, or long-term use of medicines such as glucocorticoids.

Know your baseline: bone density and fracture risk

The U.S. Preventive Services Task Force (USPSTF), in its final recommendation statement dated January 14, 2025, recommends osteoporosis screening for all women 65 and older and for postmenopausal women under 65 who are at increased risk.

Screening usually involves DXA, a quick, low-dose X-ray scan that measures bone mineral density at the hip and spine. Its T-score compares your bone density with that of a healthy young adult. Your clinician may also use a fracture-risk assessment tool.

FRAX, developed at the University of Sheffield, is one such tool. It uses age, body size, fracture history, and other factors, sometimes including bone density, to estimate your chance of a hip fracture or another major osteoporosis-related fracture over the next 10 years.

Daily actions that help bones

Calcium. The NIH Office of Dietary Supplements recommends 1,200 mg daily for women 51 and older. This is the total from food and supplements combined. Aim to get most from food, using a supplement only to fill a gap. Good sources include:

• Milk, yogurt, and hard cheeses
• Calcium-fortified plant milks and orange juice, and tofu made with calcium salts
• Canned sardines or salmon with bones
• Leafy greens such as kale and bok choy

Vitamin D. The recommended daily intake is 600 IU for adults ages 51 to 70 and 800 IU after 70, assuming minimal sun exposure. Food sources are limited, so discuss supplements if your intake is low. Some people need different amounts based on their health or a diagnosed deficiency. High doses of calcium or vitamin D can cause harm; more isn’t always better.

Protein. Adequate protein supports both muscle and bone. Include a source such as beans, eggs, fish, dairy, or tofu in your meals.

Move in ways that strengthen bone

The Bone Health and Osteoporosis Foundation highlights two types of exercise for bone health: weight-bearing activity, where your legs carry your body weight, and muscle-strengthening activity against resistance.

• Weight-bearing: brisk walking, stair climbing, dancing, and low-impact aerobics
• Muscle-strengthening: resistance bands, light dumbbells, squats, and wall push-ups

A general goal is about 30 minutes of weight-bearing activity on most days, plus strength training two to three days a week. Start at a level you can manage and build gradually. If you have low bone density or a previous fracture, ask a clinician or physical therapist which movements are safe. Forward bending and twisting under load can stress a fragile spine.

Prevent falls to prevent fractures

Most hip fractures in older adults follow a fall. Making your surroundings safer and improving balance can help reduce that risk. CDC fall-prevention guidance also emphasizes reducing hazards, checking vision, and reviewing medicines. Practical steps include:

• Remove loose rugs and cords, add bathroom grab bars, and improve stairway lighting.
• Have your vision checked regularly and keep your glasses prescription current.
• Ask a clinician or pharmacist to review medicines that may cause dizziness.
• Build strength and balance through suitable activities, such as tai chi.
• Tell your clinician about any falls, and ask about a fall-risk assessment if you’ve fallen in the past year.

When medication or hormone therapy is appropriate

If DXA shows osteoporosis, or osteopenia with a high fracture risk, your clinician may recommend medication. A previous hip or spine fracture can also be a reason for treatment. For a broader clinical discussion of postmenopausal osteopenia options, see prevent osteoporosis in women. Some medicines, including bisphosphonates and denosumab, slow bone breakdown. Others help build bone and may be considered for people at very high fracture risk.

Menopausal hormone therapy can help protect bone for some women, but it isn’t suitable for everyone. The decision depends on symptoms, age, health history, and time since menopause. Discuss expected benefits, risks, treatment length, and follow-up before choosing an approach. Mayo Clinic guidance likewise emphasizes weighing individual risks and benefits.

Discussing device-based options with your clinician

If your DXA shows osteopenia rather than osteoporosis, a prescription device may be another option to discuss. Osteoboost is a prescription vibration device with FDA clearance through the De Novo pathway for postmenopausal women with osteopenia. Ask how it could fit into your overall bone-health plan, what regular use involves, and whether insurance covers it.

Discuss the evidence and its limits, including whether studies measured fractures as well as changes in bone. This type of device is an addition to standard care for osteopenia. It is not intended to treat osteoporosis or replace prescribed medication, exercise, or fall prevention. For additional background on interpreting DXA results, see understanding bone density testing.

How to put this into a simple weekly plan

1. Review your calcium and vitamin D intake, and discuss any gaps before adding supplements.
2. Work toward weight-bearing activity on most days and strength training two to three days a week.
3. Check your home for fall hazards, including loose rugs, cords, and poorly lit stairs.
4. Ask about a DXA scan if you’re 65 or older, or younger and at increased risk, and haven’t been screened.
5. If your results show elevated risk, discuss treatment. For postmenopausal osteopenia, ask whether a prescription device such as Osteoboost could complement your plan.

FAQ

Are vibration devices or weighted vests helpful?

Osteoboost offers a prescription device-based option for postmenopausal osteopenia, subject to a clinician’s assessment. Weighted vests add load during activity, but they aren’t appropriate for everyone. Check with a clinician before using one, especially if you have low bone density, balance problems, or a previous fracture.