Menopause and bone health
The fall in oestrogen during menopause can lead to as much as 20% bone loss within a few years. That makes menopause the most important time to act, both for your symptoms and for your bone health. At OSAIA we help you with both.
What oestrogen does for your bones
Menopause is the single most important factor behind women's risk of osteoporosis. When oestrogen falls, the bones lose their main protection and bone loss speeds up sharply. In the first 5–7 years after menopause, a woman can lose up to 20% of her bone mass.
What oestrogen does for your bones
Once you understand how oestrogen protects the bones, it is easier to see why menopause is such a decisive stage for bone health.
Protects bone cells
Oestrogen keeps the balance between bone-building cells (osteoblasts) and bone-resorbing cells (osteoclasts)
Regulates calcium absorption
Oestrogen supports the body's ability to absorb calcium and hold on to it
Supports bone remodelling
Oestrogen plays a central role in the ongoing renewal of bone tissue
Bone loss through the stages of menopause
Bone loss speeds up at different rates during menopause and in the years that follow.
Perimenopause
Hormone levels start to fluctuate. Bone loss can speed up as oestrogen falls.
Bone loss
1–2% bone loss per year
Menopause
Oestrogen production falls sharply. Bone loss speeds up most during this stage.
Bone loss
Up to 20% bone loss over 5–7 years
Postmenopause
Bone loss continues, but more slowly. The risk of osteoporosis remains elevated.
Bone loss
1–2% bone loss per year
How to protect your bones in menopause
Taking action early can help you maintain your bone density and lower the risk of fractures during and after menopause.
A diet rich in calcium
- Aim for about 1,200 mg of calcium a day from food and, if you need it, from supplements
- Eat calcium-rich foods such as dairy products, leafy greens and fortified foods
- Consider a supplement if you are not getting enough from food (after discussing it with a healthcare professional)
Getting your vitamin D right
- Make sure you get enough vitamin D (typically 800–1,000 IU a day) from sunlight, food or supplements
- Have your vitamin D level checked if you need to
- Vitamin D helps the body absorb calcium and supports bone strength
Weight-bearing exercise
- Do activities that load the body regularly, such as walking, strength training or stair climbing
- Aim for 2–3 strength sessions a week to strengthen bones and muscles
- Add balance and stability exercises to lower the risk of falls
Thinking about hormone therapy
- Talk to OSAIA about hormone therapy if it is relevant for you
- For some women, hormone therapy can help slow bone loss in menopause
- The benefits and risks should always be weighed up individually
Hormone therapy: what you should know
Hormone therapy (HRT) with oestrogen can effectively slow bone loss during and after menopause. Modern HRT uses doses up to 75% lower than in the past, and is considered safe for healthy women under 60 when it is prescribed correctly and followed up. It does more than ease menopausal symptoms (hot flushes, sleep problems and vaginal dryness). It actively protects the bones and can reduce bone loss by up to 15% over 10 years.
Bone markers: is your treatment working for your bones?
Whether you are on hormone therapy or medication for osteoporosis, one of the most important questions is whether it is actually working for your bones. Bone markers answer that, faster and more precisely than waiting for the next DXA scan.
At OSAIA we use bone markers to follow up on how your treatment is affecting your bone health:
CTX measures how quickly bone is broken down. When HRT or osteoporosis medication is working well, the CTX level falls, which is a sign that bone loss has slowed.
P1NP measures how actively new bone tissue is being built. A rise in P1NP after treatment starts indicates that the skeleton is actively rebuilding.
For women in or after menopause, we usually measure bone markers at the start of treatment, after 3 months, and then once a year. That lets us document the effect, identify anyone who is not responding, and adjust the treatment plan. With our OSAIA Pro subscription, this follow-up is fully included.
Working with hormonehealthdk
Powered by hormonehealthdk
OSAIA works with hormonehealthdk for women who want advice and treatment for their hormones around menopause. Line and Mathilde are experienced nurses with master's degrees in public health and clinical nursing, and women's hormonal health is their daily focus. Together with OSAIA, you get one holistic plan that covers both your hormones and your bones.
Get started with a free pre-assessment
Not sure what you need? Book a free pre-assessment at OSAIA (max. 15 min). We look at your situation, assess whether OSAIA can help, and guide you to the right treatment and advice, whether that is osteoporosis, menopause, or both.
Book a free pre-assessmentMenopause and bones: whole-person support through menopause
Recommended start: first consultation
DKK 1,499(one-off)
- Online consultation (~30 min)
- Review of your questionnaire
- Symptoms, lifestyle and goals
- Screening for risk factors
- An introduction to menopause
- An assessment of whether hormone therapy is relevant
- A personal plan
Menopause subscription
MonthlyYearlyDKK 650/month
- Online medical pre-assessment (30–45 min with a doctor or a nurse)
- Individual assessment: symptoms, hormonal balance and bone health
- A personal treatment and lifestyle plan
- Ongoing consultations (a nurse, and a doctor when needed)
- Follow-up and adjustment: hormone therapy (if relevant) and lifestyle (diet, exercise, sleep and stress)
- Priority chat, with a reply within 24 hours on weekdays
Not included: medication and blood tests
How OSAIA helps you
From your first enquiry to a personal treatment plan, we are here when you need us.
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Book your free pre-assessment
We always start with a free, no-obligation pre-assessment of 15 minutes. You tell us about your symptoms and what is worrying you, and we assess whether OSAIA is the right place for you. You do not need a referral.
- 02
Your first consultation
Together with one of our specialists, we go through your bone health carefully. We look at your risk factors and your medical needs, including whether hormone therapy could be relevant for you. If needed, we order a DXA scan or blood tests, for example bone markers, and draw up a treatment plan that fits your everyday life.
- 03
Your personal plan and ongoing follow-up
We make a plan that suits you. Along the way we assess what is best for your situation, based on blood tests, medical treatment, diet and exercise. That means we can help you strengthen your bone health before problems appear, rather than waiting until they do.
Want to strengthen your bone health day to day?
With the OSAIA app you get expert knowledge, personal recommendations and tools, built to help you take the right steps for your bone health every day.
Read more about OSAIA AppFrequently asked questions
Answers to the questions we hear most often about menopause and bones.
Why does menopause affect the bones?
Oestrogen keeps the balance between the bone-building cells (osteoblasts) and the bone-resorbing cells (osteoclasts), supports the body's ability to absorb calcium and hold on to it, and plays a central role in the ongoing renewal of bone tissue. When oestrogen falls, bone loss speeds up.
How much bone can you lose in menopause?
The fall in oestrogen during menopause can lead to as much as 20% bone loss within a few years. That makes menopause the most important time to act, both for your symptoms and for your bone health.
When in menopause is bone loss fastest?
In perimenopause, hormone levels start to fluctuate and bone loss can speed up as oestrogen falls. Around menopause, oestrogen production drops sharply, and that is when bone loss is fastest. After menopause the loss continues more slowly, but the risk of osteoporosis remains elevated.
How do I know whether my treatment is protecting my bones?
Bone markers are measured with a blood test. CTX shows how quickly bone is broken down. When hormone therapy or osteoporosis medication is working well, the CTX level falls, which is a sign that bone loss has slowed. P1NP shows how actively new bone tissue is being built, and a rise indicates that the skeleton is rebuilding.
Keep learning
Explore related topics so you understand bone health better, and take the next step with a clearer picture of your options.
Ready to take charge of your bone health?
Join the hundreds of other patients who have chosen OSAIA on the way to better bone health. Start by booking a free pre-assessment. There is no obligation and no waiting list.
Book a free pre-assessment