Rock Those Bones & Flex Those Muscles: Staying Strong & Sexy Through Perimenopause?

Strong Foundations: Building Bone Health During Perimenopause

As women, our bones have been the silent scaffolding of our lives, supporting us. Yet, as we enter perimenopause, our bone health often takes a backseat in the midst of other changes like fluctuating hormones and shifting energy levels. 

Evenso, perimenopause is the perfect time to invest in your bone health—not as a chore, but as a way to secure a strong and vibrant future for yourself. 

In this article, we’ll uncover why bone health becomes a critical focus during perimenopause, explore the science behind these changes, and outline empowering, actionable steps to strengthen your skeletal foundation.

Why Bone Health Becomes a Focus During Perimenopause

Women naturally reach peak bone mass in their late 20s to early 30s, after which bone density gradually declines. Perimenopause accelerates this process because of changes in hormones.¹ Those changes, and the bone density changes can significantly increase the risk of osteoporosis and fractures. 

“I started doing my own research and learned that menopausal women can lose more than 3% of bone annually” AN, USA

The US National Osteoporosis Foundation estimates that women can lose up to 20% of their bone density in the first five to seven years following menopause. This is different for different groups of women: 

Caucasian Women

• Twenty percent of Caucasian women age 50 and older are estimated to have osteoporosis.
• More than half of all Caucasian women age 50 and older are estimated to have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
• Between the ages of 20 and 80, Caucasian women lose one-third of the bone mineral density in their hip.

About 15 percent of Caucasians are lactose intolerant, which can make it difficult to get enough calcium.²

African-American Women

• Five percent of African American women older than 50 are estimated to have osteoporosis.
• Another 35 percent are estimated to have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
• Recent research shows that even among African American women who do have risk factors for osteoporosis, few are screened for the disease.
• About 70 percent of African Americans are lactose intolerant, which can make it difficult to get enough calcium.

Many African American women don’t get enough vitamin D, which can make it hard for the body to absorb calcium.³

Asian Women

• About 20 percent of Asian American women age 50 and older are estimated to have osteoporosis.
• More than half of all Asian American women age 50 and older are estimated to have low bone density, which means their bones are getting weaker but they don’t yet have osteoporosis.
• About 90 percent of Asian American adults are lactose intolerant, which can make it difficult to get enough calcium.⁴

Hispanic and Latina Women

• Ten percent of Latinas have osteoporosis.
• Half of all Latinas older than 50 have low bone mass, which means their bones are getting weaker but they don’t yet have osteoporosis.
• Many Latinas are lactose intolerant, which can make it difficult to get enough calcium.
• Hip fractures among Latinas in the United States appear to be on the rise.⁵

How does bone loss happen in perimenopause? 

Bone is a living tissue that undergoes continuous remodeling – this gives us hope! Specialized cells break down old bone and build new bones. Up until our 30s, the cells that make bone work faster than the ones that break it down. But as estrogen levels decline during perimenopause, this balance shifts:

• Reduced Estrogen: Estrogen slows the activity of the cells that can rebuild bone. So the cells that break down bone keep working, but it is not being rebuilt at the same pace leading to an overall loss of density.  

• Calcium and Vitamin D Deficiency: Hormonal shifts can reduce calcium absorption in the intestines, which is critical for maintaining bone strength. Vitamin D, is key for calcium absorption and often becomes insufficient if women spend less time outdoors or age.
• Slower Bone Formation: As we age, the natural process of bone remodeling slows, exacerbating the effects of hormonal changes.

Understanding these biological mechanisms gives us the knowledge to act. Bone loss isn’t inevitable—it’s a signal to take charge of your health and actively build your bone bank for the future.

How do we build our bone banks? 

Feed Your Bones- recreate your foundations

• Increase Calcium Intake: Calcium is the cornerstone of bone health. Incorporate calcium-rich foods like dairy products, leafy greens, almonds, and fortified plant-based milks into your diet. Aim for 1,200 mg of calcium daily during perimenopause.⁶
• Boost Vitamin D: Known as the sunshine vitamin, Vitamin D helps your body absorb calcium. Get 10-15 minutes of sunlight exposure daily and consider foods like fatty fish, egg yolks, and fortified cereals. Supplements can also help, with most guidelines recommending 600-800 IU per day.
• Eat Magnesium and Vitamin K: Magnesium (found in nuts, seeds, and whole grains) and Vitamin K (found in broccoli, spinach, and fermented foods) play supportive roles in bone health.
• Protein Matters:  Your bones need protein to stay strong. Include lean meats, fish, beans, and tofu in your meals.⁷

Build Bone Strength⁸

Physical activity isn’t just good for your heart—it’s essential for your bones:

• Weight-Bearing Exercises: Activities like walking, jogging, and dancing stimulate bone formation by putting stress on your bones, encouraging them to grow stronger.
• Resistance Training:  Lifting weights or using resistance bands builds muscle, which indirectly supports bone density by strengthening the muscles that surround and stabilize your bones.
• Balance and Flexibility Work:  Yoga, Pilates, or tai chi improve your balance, reducing your risk of falls and fractures.

Everyday Bone Boosters

• Quit Smoking:  Smoking accelerates bone loss by reducing blood flow to the bones and impairing calcium absorption.
• Limit Alcohol:  Excessive alcohol consumption can weaken bones over time. Keep it to one drink per day or less.
• Maintain a Healthy Weight:  Being underweight can increase bone loss, while obesity can lead to joint and bone strain. Strive for a balanced weight through healthy eating and exercise.

Take control 

• Bone Density Testing:  A simple DEXA scan can help you understand your current bone health and identify any early signs of osteoporosis.
• Medications and Supplements: If you’re at high risk for bone loss, your doctor may recommend bisphosphonates, hormone replacement therapy (HRT), or other medications that slow bone breakdown and support density.

Invest in you

• Treat this phase as an investment in you. Every step you take—whether it’s swapping soda for milk, adding a daily walk, or setting aside a few moments to stretch—helps secure your future health.
• Reward yourself for progress. Celebrate milestones like completing a month of weight training or adding a new calcium-rich recipe to your repertoire.

Your Bone Health Is Your Superpower

It is easy to think of perimenopause as a time of inevitable decline, but at FemTalkAsia we like want to be more positive than that, and to think of this time as a chance to reconnect with your body in a meaningful way. Your bones are more than a structural framework—they’re a testament to your strength and resilience. Every effort you make to care for them today is a step toward a vibrant, independent future.

References

1. Susan L. Greenspan, Penelope Coates, Susan M. Sereika, Joel B. Nelson, Donald L. Trump, Neil M. Resnick, Bone Loss after Initiation of Androgen Deprivation Therapy in Patients with Prostate Cancer, The Journal of Clinical Endocrinology & Metabolism, Volume 90, Issue 12, 1 December 2005, Pages 6410–6417, https://doi.org/10.1210/jc.2005-0183
2.  Kanis, J. A., Johnell, O., Oden, A., Dawson, A., De Laet, C., & Jonsson, B. (2001). Ten year probabilities of osteoporotic fractures according to BMD and diagnostic thresholds. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 12(12), 989–995. https://doi.org/10.1007/s001980170006
3.  Cauley, J. A., Fullman, R. L., Stone, K. L., Zmuda, J. M., Bauer, D. C., Barrett-Connor, E., Ensrud, K., Lau, E. M., Orwoll, E. S., & Mr. OS Research Group (2005). Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 16(12), 1525–1537. https://doi.org/10.1007/s00198-005-1866-8
4.  Zhou, Y., Li, Y., Zhang, D., Wang, J., & Yang, H. (2010). Prevalence and predictors of osteopenia and osteoporosis in postmenopausal Chinese women with type 2 diabetes. Diabetes research and clinical practice, 90(3), 261–269. https://doi.org/10.1016/j.diabres.2010.09.013
5.   Cauley, J. A., Fullman, R. L., Stone, K. L., Zmuda, J. M., Bauer, D. C., Barrett-Connor, E., Ensrud, K., Lau, E. M., Orwoll, E. S., & Mr. OS Research Group (2005). Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 16(12), 1525–1537. https://doi.org/10.1007/s00198-005-1866-8
6.  Furkatovna, A. M. (2022). Vitamin D Deficiency in Menopausa Women. The Peerian Journal, 5, 77-80.
7.  Willoughby, D. S., Florez, C., Davis, J., Keratsopoulos, N., Bisher, M., Parra, M., & Taylor, L. (2024). Decreased neuromuscular function and muscle quality along with increased systemic inflammation and muscle proteolysis occurring in the presence of decreased estradiol and protein intake in early to intermediate post-menopausal women. Nutrients, 16(2), 197.
8.  Capel-Alcaraz, A. M., García-López, H., Castro-Sánchez, A. M., Fernández-Sánchez, M., & Lara-Palomo, I. C. (2023). The efficacy of strength exercises for reducing the symptoms of menopause: a systematic review. Journal of clinical medicine, 12(2), 548.