A woman’s guide to lifelong bone health
I had a bone density scan this week to check the progression of my osteopenia (lowered bone density). I’m in my early 50s, which is a prime time for developing this condition and I have certain risk factors that have contributed to developing osteopenia (that’s a story for another day). However, it reminded me just how important it is that we look after our bones. This is particularly the case for women, as we all lose some bone mass in the first 5-7 years post menopause due to declining estrogen. This is because estrogen promotes bone formation and protects against bone loss.
Bone health is, however, a lifelong journey — not just a concern for older women. From building strong bones in childhood to preventing fractures later in life, every stage requires tailored strategies. For women especially, hormonal changes, lifestyle factors, and aging can all affect bone density. The good news is that there is plenty we can do to prevent big losses – and no, it’s not just dietary calcium and calcium supplementation!
Why Bone Health Matters
Bone is living tissue that constantly breaks down and rebuilds. By around age 25, women typically reach peak bone mass. After that, bone density tends to stabilize until midlife, when it begins to decline — especially during and after menopause. If bone loss becomes severe, osteoporosis can develop, greatly increasing the risk of fractures.
So what can we do you might ask. Building good habits early and continuing them can protect bone strength for decades. Here are a few tips for building strong bones at every age.
Childhood & Adolescence - Maximize peak bone mass.
Calcium (1000–1300 mg/day) from dairy, fortified plant milks, tofu, and leafy greens.
Vitamin D through safe sun exposure and supplements if needed.
Physical activity, especially weight-bearing and high-impact sports like jumping or running.
Avoid restrictive diets that can cause nutrient shortfalls.
Teenagers: Avoid excessive dieting or overtraining, especially if it leads to menstrual irregularities.
Young Adulthood (20s–30s): Maintaining Peak Bone Mass
Keep up calcium and vitamin D intake.
Engage in strength training and impact exercises.
Avoid excessive dieting or overtraining, especially if it leads to menstrual irregularities – yes, I’m repeating myself but this is a big issue for women of all ages unfortunately
Watch for low energy availability in active women and athletes (a risk for bone loss).
Pre-Menopause (30s–40s): Staying strong and preventing early bone loss
Continue weight-bearing and resistance exercises. Include some jumping exercises 3-5 minutes a day (rope jumping, jumping on one leg) and balancing exercises (stand on one leg whilst brushing your teeth).
Maintain adequate calcium intake (1000 mg/day from food and supplementation if needed) and vitamin D.
Monitor thyroid health, as both underactive and overactive thyroid can affect bone.
Limit excessive alcohol, caffeine and salt intake.
Perimenopause & Menopause (Mid-40s and Beyond): Minimize bone loss and prevent fractures
Bone loss can accelerate rapidly during this stage due to declining estrogen levels.
Increase calcium intake (1300 mg/day (from food and supplementation if needed).
Boost vitamin D, depending on sun exposure and blood levels.
Prioritize protein (2-2.3 g/kg/day), essential for bone and muscle.
Resistance and impact exercises become even more critical.
Include phytoestrogens like soy and flaxseeds, which may offer mild bone support.
Discus menopausal hormone therapy (MHT, formerly known as HRT) with your doctor if appropriate.
Consider supplements for the key bone co-factors like magnesium, vitamins K1 & K2 and others (this is something to discuss with your healthcare provider).
Implement fall prevention strategies such as balance and mobility training.
Older Age (65+): Preserving Strength and Preventing Falls
Continue or adapt resistance and weight-bearing exercises.
Ensure adequate protein intake (up to 1.5–2.0 g/kg/day).
Stay consistent with calcium and vitamin D.
Regularly review medications, as some (like corticosteroids or PPIs) can impact bone health.
Keep up with balance and mobility exercises like tai chi or yoga.
Supplement with bone-supporting nutrients as needed.
Universal Tips for All Ages
Don’t smoke — it accelerates bone loss.
Limit alcohol — excessive intake weakens bones.
Stay active — even light daily movement supports bone turnover.
Monitor bone density (DEXA scans) periodically, especially after menopause or with risk factors. In Australia, Medicare only covers DEXA scans after the age of 70. I would highly recommend having your first scan in your 50s to get a baseline measurement. Yes, you will have to pay for it (about $180) but it’s well worth it, especially if you have risk factors like coeliac disease, diabetes, thyroid conditions, anorexia nervosa, amenorrhoea (loss of your period for 3 months or more), rheumatoid arthritis, had prolonged corticosteroid treatment and others.
Final Thoughts
Whilst the above guide applies to all women, some of us might need a little extra help to maintain good bone density. If you would like to find out what foods to eat, what supplements to take and which dosage you need (we all have different requirements) and what else you can do to protect your bones, book in for a 1:1 consultation with me (you can make a booking via my services page).
References:
Healthy Bones Australia (2025). Calcium & bone health. https://healthybonesaustralia.org.au/your-bone-health/calcium/
Rizzoli, R., Biver, E., Bonjour, JP. et al. (2018). Benefits and safety of dietary protein for bone health—an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteopororosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation. Osteoporos Int 29, 1933–1948. https://doi.org/10.1007/s00198-018-4534-5
Romm, A. (2018). Botanical Guide to Women’s Health (2nd ed.). Elsevier.
Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., Janse de Jonge, X. A. K., Hirsch, K. R., Arent, S. M., … Antonio, J. (2023). International society of sports nutrition position stand: nutritional concerns of the female athlete. Journal of the International Society of Sports Nutrition, 20(1). https://doi.org/10.1080/15502783.2023.2204066
Wilkinson, D. J., Bukhari, S. S. I., Phillips, B. E., Limb, M. C., Cegielski, J., Brook, M. S., Rankin, D., Mitchell, W. K., Kobayashi, H., Williams, J. P., Lund, J., Greenhaff, P. L., Smith, K., & Atherton, P. J. (2018). Effects of leucine-enriched essential amino acid and whey protein bolus dosing upon skeletal muscle protein synthesis at rest and after exercise in older women. Clinical nutrition, 37, 2011–2021. https://doi.org/10.1016/j.clnu.2017.09.008
