Menopause, as we know, is often associated with symptoms like hot flashes, mood changes, low libido, and sleep disruption. But that is the tip of the iceberg for menopause. We have issues under the surface that are happening simultaneously. One of the most important and overlooked changes is what is happening to our bones. Our bones lose bone density and become thinner and frailer. Since bone loss doesn’t hurt and we don’t see it…one might ask why we are worried? What is the risk of having thin bones? What can we do?
Bone is a living tissue that is constantly broken down and replaced. Osteopenia and osteoporosis occur when the creation of new bone doesn’t keep up with the loss of old bone. Think of trying to build a snowman in the summer. The snowman keeps melting as you try to add more snow. A losing battle.
When we start the menopause transition (MT) we have a reduction in estrogen. There is a direct correlation to estrogen and bones. Estrogen helps maintain the balance between bone formation and resorption. A lack of estrogen adversely affects the osteoblast (cells that build bone), leading to a major imbalance in the bone remodeling process. Hence, we continue to break down bone RAPIDLY while SLOWLY building up. It’s like taking one step forward and two steps backward. Very hard to finish a race at that pace!
The Hidden Decline
The degradation of our bones is happening insidiously. During the menopause transition there is a rapid phase of bone mineral density loss in the 3-year period around the final menstrual period. After this time, the bones continue to degrade but less rapidly.
As estrogen levels decline during menopause, women can lose up to 20% of their bone density in the first 5–7 years of menopause. This significantly increases the risk of osteoporosis and fractures. Fractures of the wrist, hip and vertebrae are the main clinical manifestations of osteoporosis and have an enormous impact on quality of life. This results in a significant economic burden and is associated with considerable excess mortality.
Why Impact Matters
Here is the empowering news: movement, especially impact exercise like running or walking, can help protect and even strengthen your bones.
- Bones are living tissue. They respond to stress and load by becoming stronger. This is known as mechanical loading. When your foot strikes the ground while running, it sends a signal to your bones to remodel and reinforce themselves.
- Unlike low-impact activities like swimming or cycling, running provides:
- Ground reaction forces that stimulate bone growth
- Weight-bearing resistance that strengthens hips and spine
- Improved muscle mass, which further supports skeletal health
Think of running as medicine. Think of running as a natural prescription for bone health. Regular impact activity has been shown to:
- Slow bone loss during menopause
- Improve bone mineral density, especially in the hips
- Reduce the risk of fractures later in life
Even short runs or incorporating intervals of jogging into your routine can make a difference. We call these exercise snacks. If 30 minutes of vigorous exercise daily is too much, go for 10 minutes daily. Every bit helps.
Balance Is Key
While impact is beneficial, recovery and variety matter — especially during menopause. Hormonal changes can also affect joints, tendons, and recovery time.
To run strong and stay injury-free:
- Combine running with strength training (especially resistance exercises)
- Prioritize rest and recovery — aim for 7 hours sleep nightly
- Ensure adequate calcium, vitamin D, and protein intake
- Calcium — should be provided through the foods you eat — about 1000 mg daily
- Please use caution when taking supplements (kidney stones and cardiac calcifications). Check with your MD
- Vitamin D — 600–1000 IU daily
- Protein — 1.0–1.2 grams of protein per kilogram of body weight per day
- Listen to your body — adjust intensity of exercise as needed
- Don’t smoke and limit alcohol intake
Who is at Risk?
In the United States, 10 million people live with osteoporosis. Women account for 80% of diagnoses and the condition affects about 1 in 4 women age 65 or older. Generally, the risk of osteoporosis increases with age. About 1 in 3 women will suffer a fragility fracture (break a bone) due to osteoporosis in their lifetime.
Highest risk groups:
- Women
- Smokers
- Long-term steroid users
- Heavy alcohol users
- Sedentary lifestyle
The Bigger Picture
Running during menopause isn’t just about bone health. It supports cardiovascular health, mental clarity, mood regulation, and weight management — all areas that can shift during this phase of life.
Most importantly, it helps women feel strong, capable, and in control of their changing bodies.
Final Thought
Menopause is not a time to slow down — it’s a time to get strategic. Every step you take while running is not just forward motion — it’s an investment in your long-term strength and independence. The sooner you start fitness the better. Prevention is better than trying to cure osteopenia or osteoporosis.
So lace up. Your bones will thank you.
Angela M. Sterious FNP, PMHNP-BC
References
https://www.drvondawright.com/resources/books/unbreakable
https://www.drvondawright.net/betterbone
https://www.healthline.com/health/osteoporosis/estrogen-and-osteoporosis#prevention
https://pmc.ncbi.nlm.nih.gov/articles/PMC6226267/
https://www.mayoclinic.org/diseases-conditions/osteoporosis/diagnosis-treatment/drc-20351974
https://www.healthline.com/health/osteoporosis/estrogen-and-osteoporosis
https://pmc.ncbi.nlm.nih.gov/articles/PMC10009319/
