Menopause and the Hidden Risk of Osteoporosis
National Osteoporosis Awareness Month with Dr Jackie Radley
Menopause, Bone Health & Why Menopause Matters
May is Osteoporosis Awareness Month—a vital opportunity to highlight a silent, often overlooked condition that affects over 3 million people across the UK. While osteoporosis can impact anyone, women approaching or going through perimenopause and postmenopause face a significantly increased risk. This is the stage in life when oestrogen levels decline, triggering a range of symptoms that go beyond hot flushes, brain fog, and mood changes—including the rapid loss of bone density.
Midlife is already a time of major physical and emotional shifts, and the added risk of fractures or bone thinning is one many women aren’t warned about. That’s why it’s so important to raise awareness of the link between menopause and osteoporosis—and more importantly, what women can do to protect themselves.
To guide this conversation, we’re joined by Chief Medical Officer: Dr. Jackie Radley, a leading expert in menopause care.
Dr. Radley is an Advanced Menopause Specialist, GP, and founder of the Birmingham Menopause Clinic.. With a special interest in hormone replacement therapy (HRT) and a holistic, lifestyle-focused approach, she supports women in navigating all aspects of the menopause journey—from symptom relief to long-term health, including bone strength and osteoporosis prevention.
Why oestrogen matters
Osteoporosis causes bones to become fragile and more likely to break, often without warning. The reason it disproportionately affects women during menopause? Oestrogen.
During menopause, the ovaries stop producing the hormones oestrogen and progesterone, and they no longer release eggs. Oestrogen plays a vital role in maintaining bone density by interacting with and inhibiting the cells responsible for breaking down bone, a natural part of the bone remodelling process. As oestrogen levels decline rapidly during menopause, this balance is disrupted, leading to an accelerated rate of bone loss. In fact, women can lose up to 20% of their bone density in the 5–7 years around and after menopause.
The Fracture Risk—Why Bone Loss Matters More Than You Think
Reductions in bone density increase the risk of osteoporosis fractures – also known as fragility fractures – whereby the bones break due to normal activities or minor trauma, such as falling from standing height. In fact, 1 in 2 women will experience a fracture due to osteoporosis at some point in their lifetime .
Osteoporotic fractures, particularly those of the hip and spine, are especially serious, as they are associated with an increased risk of mortality within the first 6 to 12 months following the fracture.
Silent But Serious—Spotting Osteoporosis Before It Strikes
Unfortunately, osteoporosis is a silent disease – often patients will have no symptoms until fracture… and that’s why awareness is so important.
That being said, some patients may experience a stooped posture/loss of height, some bone and/or joint pain, or possibly back pain.
Despite this, there are ways to stay ahead:
- Risk factors include: Premature Ovarian Insufficiency (POI) - menopause before the age of 40, early menopause (before age 45), family history, smoking, excessive alcohol, and low BMI.
- Consider a bone density scan (DEXA scan)—especially if you’ve gone through an early menopause, have had fractures, or are taking medications like steroids.
Everyday Prevention—How to Protect Your Bones During and After Menopause
You don’t have to wait for a fracture to take action. Whether you’re in your 40s, navigating perimenopause, or already postmenopausal, it’s never too early—or too late—to start prioritising your bone health.
Bone loss can begin long before symptoms of osteoporosis appear–or don’t appear–but there are powerful, evidence-based ways to protect and strengthen your bones throughout midlife and beyond. Prevention and management are key pillars of long-term bone health—and many of these strategies can also help ease other menopausal symptoms:
- 🥦 Eat calcium-rich foods like dairy, leafy greens, tofu, and fortified products to support bone strength.
- ☀️ Top up on vitamin D through safe sun exposure or daily supplements, particularly during the winter months, to help absorb calcium.
- 🏋️ Stay active with weight-bearing exercises like walking, dancing, or strength training to maintain bone density.
- 🚭 Quit smoking and cut down on alcohol, both of which weaken bones.
- ⚖️ Keep a healthy weight—being underweight increases your osteoporosis risk.
How HRT Supports Bone Health—Replacing Lost Oestrogen to Prevent Bone Loss
Hormone Replacement Therapy (HRT) is one of the most effective ways to protect bone health during and after menopause. By replacing the oestrogen that naturally declines during this time, HRT helps slow down bone loss and maintain bone density, significantly reducing the risk of osteoporosis and fractures. For many women, especially those under 60 or within 10 years of menopause, HRT offers both relief from menopausal symptoms and long-term protection for their bones.
Have an open conversation with your GP about your menopause journey, bone health and available options – or book to see a menopause specialist
Menopause Doesn’t Have to Mean Weaker Bones
Osteoporosis doesn’t have to be an inevitable part of menopause. By talking about it, testing for it, and taking preventive steps, women can protect their independence, mobility, and quality of life.
Take control of your bone health
Strong bones start with informed choices
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