Osteoporosis and Women: Reducing Your Risk
Osteoporosis is a condition in which bones become thinner, less dense and more likely to break, and it affects women far more often than men. Around one in three women over 50 will experience an osteoporotic fracture, most commonly of the wrist, spine or hip. The good news is that much of it is preventable, and even after a diagnosis there is plenty that can be done. This guide explains why women are affected and how to protect your bones.
What osteoporosis is
Bone is living tissue, constantly broken down and rebuilt. Up to around age 30 you build more bone than you lose, reaching peak bone mass. After that, especially in the years after the menopause, the balance tips and bone is lost faster than it is replaced. When bone becomes porous and fragile, a cough or a stumble can cause a break.
Why women are affected more
The biggest reason is the menopause. Oestrogen protects bone, and when levels fall sharply, bone loss speeds up dramatically in the first few years after your final period. Women also tend to have smaller, thinner bones than men, so less loss is needed before fractures become a risk. An early menopause before age 45, or removal of the ovaries, raises the risk further.
Other risk factors to know about
- A family history of osteoporosis or hip fractures
- Long-term use of steroid tablets, such as for asthma or arthritis
- Low body weight or a history of eating disorders
- Smoking and drinking alcohol above recommended limits
- Conditions that affect absorption, such as coeliac disease, and long periods of being less mobile
Some of these you cannot change, but knowing about them means you can take extra care with the ones you can.
What to eat for stronger bones
Calcium and vitamin D are the two nutrients your bones cannot do without. Calcium is the building material and vitamin D lets your body absorb it. A daily supplement of 10 micrograms of vitamin D is recommended from October to March, and all year round if you spend little time outdoors.
| Food | What it offers |
|---|---|
| Milk, yogurt and cheese | Calcium, and some yogurts are fortified with vitamin D |
| Leafy greens such as kale and broccoli | Calcium plus vitamin K, which also supports bone |
| Canned sardines or salmon with bones | Calcium and vitamin D together |
| Fortified cereals, breads and plant milks | Easy way to top up calcium and vitamin D |
| Tofu, beans and lentils | Calcium and protein, which is part of the bone scaffold |
Exercise that actually helps bones
Bones respond to impact and to muscle pulling on them. Weight-bearing activities such as brisk walking, dancing, hiking, tennis and stair climbing tell your bones to stay strong. Resistance work with weights or bands strengthens the muscles around your bones and improves balance, cutting the risk of falling. The combination is most effective. Always check with a pharmacist or GP before starting a new programme if you have health conditions.
When a bone scan is offered
A DEXA scan measures bone density at the hip and spine and is the standard way to diagnose osteoporosis. It is not offered to everyone; your GP will consider it if you have had a fracture after a minor fall, are older with other risk factors, or take long-term steroids. If you had an early menopause, mention it, because that alone can justify an earlier scan. The menopause and HRT guides explain how hormones protect bone.
If you are diagnosed
A diagnosis is not the end of the story. Medicines called bisphosphonates reduce the risk of breaking a bone, and there are alternatives if they do not suit you. Alongside medication, the same diet and exercise advice applies, and physiotherapy can build confidence after a fracture. Keep moving, carefully, because immobility accelerates further bone loss.
Bone health is one of the few areas where habits built in your forties and fifties decide what happens in your seventies. Eat for your bones, stay active, and never let a menopause or a fracture pass without asking whether a check is warranted.