5 Things Women Experiencing Menopause Should Know About Osteoporosis Risk
Updated on May 7, 2025
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The degenerative bone disease osteoporosis is underdiagnosed and undertreated — even though it affects almost 20 percent of women older than 50 in the United States (and 5 percent of men that age).
Women are at a particular risk of osteoporosis after menopause, when up to 20 percent of bone loss can occur. Yet research shows there’s widespread misinformation among postmenopausal women about the risks of osteoporosis and precautions that should be taken to prevent complications like falls and fractures.
Here are five important facts every woman should know.
1. Be Aware of Brittle Bones, as Well as Breaks
Osteoporosis occurs when our bones lose too much mineral density and mass. The resulting brittle bones are vulnerable to fracture, which can seriously impact a person’s health and well-being. Women are more prone than men because of hormone changes during menopause that speed up bone loss.
Waiting for a fracture to occur before you get serious about the disease is dangerous, notes Ira Khanna, MD, an assistant professor of rheumatology at Mount Sinai West in New York City. “You want to catch low bone mass even before it becomes osteoporosis and certainly before there’s a bone break,” Dr. Khanna says.
There’s significant misinformation and misunderstanding about menopause, says Stephanie Faubion, MD, the director of the Mayo Clinic's Center for Women's Health and the medical director of the North American Menopause Society. Most people don’t realize they have osteoporosis until they break a bone.
2. Osteoporosis Is Serious — and Sometimes Deadly
Osteoporosis makes it more likely that a wrist, forearm, spine, or hip bone will fracture. Especially in older people whose bones heal more slowly, these breaks can have lasting effects, Khanna says. They may experience lingering pain, the inability to stand up straight, or difficulty living on their own.
In its most severe form, osteoporosis can be deadly. One study found that 17 percent of people with osteoporosis who broke their hip died within one year. In a survey of 240 postmenopausal women living in China, a majority thought osteoporosis was less dangerous than heart disease, and more than a third incorrectly ranked it behind high blood pressure and diabetes. In fact, all four together are considered the most perilous health threats, the researchers noted.
Respondents also did not recognize the silent nature of the condition. Some 41 percent said they would seek treatment only after experiencing pain or another adverse event. Again, that is well after effective treatment should begin, Khanna says.
3. Lifestyle Changes Can Reduce Osteoporosis Risk
To keep your bones as strong as possible in midlife and after, it’s important to adopt a healthy lifestyle. This includes regular weight-bearing exercise such as walking, running, or strength training; limiting alcohol use; quitting smoking; and eating a healthy diet with adequate amounts of calcium and vitamin D.
Most people get sufficient calcium in their diet and don’t need supplements, Khanna says, pointing to milk, soy foods, leafy greens, oats, and beans as especially good sources.
But many women are deficient in vitamin D, which is why she recommends asking your doctor to test your level along with your regular blood work and supplementing as necessary.
People with osteoporosis should also take care to prevent falls, by removing floor rugs, installing grab bars in the bathtub and shower, and having regular eye exams so they don't accidentally trip on obstacles they don’t see.
4. Ask Your Doctor About Getting a Bone Density Test
The strength of your bones can be evaluated with an imaging scan known as dual-energy X-ray absorptiometry (DXA).
The U.S. Preventive Services Task Force (USPSTF) currently recommends that women at average risk for osteoporosis have their first screening at age 65. Postmenopausal women who are not yet that age but are at risk should also be screened, the USPSTF states. This includes a family history of osteoporosis, inflammatory bowel or thyroid disease, certain medications, including steroids or anti–breast cancer hormones, and many other factors, Khanna says.
You can check your risks with an online calculator known as a FRAX Risk Assessment tool. Then speak with your physician about the right time to have a DXA screen.
Tests should be repeated every two years after the first one, Khanna notes.
In the United States, screening rates currently fall well below the recommendations. Research has found that just 25 percent of people who should be screened undergo appropriate testing.
5. Medicines Can Help
Postmenopausal women with osteoporosis or osteopenia — low bone mass levels that precede osteoporosis — should be treated with medication, Khanna says. Medicines include biphosphonates such as alendronate (Fosamax), zoledronic acid (Reclast), and ibandronate (Boniva), which slow the rate at which bones break down.
People with more severe disease may also need medicines that increase bone formation, such as teriparatide (Forteo), abaloparatide (Tymlos), or romosozumab (Evenity), she advises.
Medications are a crucial component of treatment and reduce the risk of broken bones. Research has found that individuals with high-risk osteoporosis who are not taking medication to treat the disease have a 23 percent chance of a major fracture over a 10-year period.
Hormone therapy with estrogen is another option for reducing fracture risk, Dr. Faubion says, especially for younger, healthy postmenopausal women who also have hot flashes, which estrogen also helps with. It’s not, however, appropriate for everyone, given the potential risks linked to estrogen therapy.
The Takeaway
- Osteoporosis often goes undiagnosed until after a fracture, yet early screening and lifestyle changes can significantly reduce risk and improve quality of life.
- Postmenopausal women are at a particularly high risk of osteoporosis, but many are unaware of or misinformed about the dangers.
- Medications, hormone therapy, and fall-prevention strategies can help maintain bone strength and prevent life-altering fractures.
Resources We Trust
- Mayo Clinic: Osteoporosis
- Cleveland Clinic: Osteoporosis: Symptoms, Causes, and Treatment
- National Institute on Aging: Osteoporosis
- International Osteoporosis Foundation: What Is Osteoporosis?
- Bone Health & Osteoporosis Foundation: Preventing Falls
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Osteoporosis. National Institute on Aging. November 15, 2022.
- How to Prevent Osteoporosis After Menopause. Cleveland Clinic. May 12, 2022.
- Liu J et al. The Prevalence of Osteoporosis in Postmenopausal Women in Urban Tianjin, China and Its Related Factors. Menopause. July 2023.
- Osteoporosis. Mayo Clinic. February 24, 2024.
- What Is Osteoporosis? International Osteoporosis Foundation.
- Morri M et al. One-Year Mortality After Hip Fracture Surgery and Prognostic Factors: A Prospective Cohort Study. Scientific Reports. December 10, 2019.
- What Can You Do Now to Help Prevent Osteoporosis. Johns Hopkins Medicine.
- Vitamin D Deficiency. Cleveland Clinic. August 2, 2022.
- Preventing Falls. Bone Health & Osteoporosis Foundation.
- Facts About Bone Density (DEXA Scan). Centers for Disease Control and Prevention. January 30, 2025.
- Osteoporosis to Prevent Fractures: Screening. U.S. Preventive Services Task Force. January 14, 2025.
- Sabri S et al. Osteoporosis: An Update on Screening, Diagnosis, Evaluation, and Treatment. Orthopedics. July 25, 2022.
- Osteoporosis. Mayo Clinic. February 24, 2024.
- Medications for Prevention and Treatment. Bone Health & Osteoporosis Foundation.
- McCloskey E et al. The Osteoporosis Treatment Gap in Patients at Risk of Fracture in European Primary Care: A Multi-Country Cross-Sectional Observational Study. Osteoporosis International. August 23, 2020.
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Anna L. Goldman, MD, is a board-certified endocrinologist. She teaches first year medical students at Harvard Medical School and practices general endocrinology in Boston.
Dr. Goldman attended college at Wesleyan University and then completed her residency at Icahn School of Medicine at Mount Sinai Hospital in New York City, where she was also a chief resident. She moved to Boston to do her fellowship in endocrinology at Brigham and Women's Hospital. She joined the faculty after graduation and served as the associate program director for the fellowship program for a number of years.
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