How Menopause Affects Bones and Muscles and What You Can Do About It
- Jul 9, 2024
- 5 min read
Updated: Jun 3
Miyara Women | Jul 9, 2024 | Updated: Nov 30, 2024
Written by: Kanchana — Lifestyle Consultant & Weight Management Specialist, Calorie Culture
Does that look like a page out of your planner?
Midlife is often the busiest time in a woman's life — work, family, elderly care, parental challenges, financial commitments — keeping her always on her toes. But to sustain peak efficiency, is it enough to only have a mind that works at the speed of light?
Unfortunately not. The body must follow suit. And ironically, women experience joint problems and muscle fatigue earlier in life and more than men.
Women experience joint problems and muscle fatigue earlier in life and more than men.
In women, muscle mass decreases by ~3–8% per decade after age 30 and as much as 20% of bone loss can occur during menopause.
This matters especially in India: with ~46 million Indian women estimated to have osteoporosis — and India ranking among the highest globally for osteoporosis burden — low calcium intake and widespread vitamin D deficiency compound the hormonal risk that every menopausal woman already faces.
This happens because bones and muscles are sensitive to estrogen, which aids bone formation and strengthening and supports muscle mass and force-generating capacity. FSH (follicle-stimulating hormone) accelerates the breakdown of bones. The decline in estrogen and rise in FSH during the menopausal transition hit a double-whammy on bone health — accelerating bone loss and diminishing muscle strength simultaneously.
When life throws lemons in the face of women (aging and menopause-associated hormonal fluctuations), can they make lemonade out of it?
Read on to understand how women can turn the tables to their advantage.
Lifestyle Changes to the Rescue
Fortunately, there are workarounds — but they require discipline. The challenge lies in making proactive, conscious changes to daily routines. If you are persistent, you can not only slow down bone and muscle degeneration but may even build them back. Here are the dos and don'ts for being the fittest you can be as you age.
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Food as Fuel
Calcium is the primary ingredient that makes up the bones. The lower the calcium, the weaker your bones — and without strong bones, strong muscles are virtually impossible. You need around 1000 mg daily — more if you are over 50, pregnant, or breastfeeding.
Vitamin D is calcium's supervisor: it ensures that the calcium you consume is absorbed and deposited in the bones. Lower vitamin D levels are associated with depression, mood swings, brain fog, stress urinary incontinence, pelvic organ prolapse, sleep disturbances, and sexual dysfunction — in other words, it can worsen the full spectrum of menopause symptoms. Most adults need 400 IU per day. Your body can make its own vitamin D with direct sunshine on your skin. If you are on a plant-based diet, supplementation is likely necessary.
Protein is the primary ingredient that makes up your muscles. Without adequate protein, building or maintaining muscle mass is difficult. Requirements vary between 0.8–1.2g per kg body weight depending on age and activity level. With a little planning, even vegans and vegetarians can meet this.
Magnesium — About 60% of your magnesium stores are in your bones, and a significant amount in your muscles too. It has proven benefits in reducing inflammation and oxidative stress, both risk factors for osteoporosis — with added benefits for mood, sleep, and exercise performance.
Fruits and Vegetables are powerhouses of vitamins, minerals, fibre, and antioxidants — without which the above nutrients cannot function effectively. The fibre feeds your gut bacteria, which are implicated in the maintenance of healthy bones. Aim for at least 5 portions (1 portion = 80g) daily. Variety is key.
Fitness as a Stimulus
Exercise — and specifically strength training — is another crucial component. A 2024 meta-analysis in PM&R, covering 19 trials and 1,249 postmenopausal women, found that combining multiple exercise types significantly improved lumbar spine bone mineral density — making a mixed routine (strength + weight-bearing + aerobic) more effective than any single modality alone.
Greater Bone Density — Weight-bearing exercises and resistance training stimulate bone cells to grow, compensating for the negative hormonal impact.
Increased Muscle Mass — Strength training builds and maintains muscle, provided good nutrition and sufficient recovery are in place.
Improved Metabolism — More muscle means more calorie-burning power and better insulin sensitivity, which often declines with falling estrogen during perimenopause. This helps keep weight in check, which further benefits bone health.
In general, 45–50 minutes of strength training, 3–4 times a week, is recommended if you are healthy. Don't write off walking, dancing, or stair climbing — staying active throughout the day does wonders for bone and muscle health too.
The best way to devise a training plan that suits you is by talking to an expert.
In general, 45-50 minutes of strength training, 3-4 times a week, is recommended if you are healthy. You can use heavier weights or increase the intensity as your strength improves. But don’t write off activities like walking, dancing, or stair climbing just yet. Staying active throughout the day does wonders for your bone and muscle health too.
You can incorporate these activities every day of the week, or, at the very least, on your off days from strength training.
Other Habits That Count
Hydration — Your muscles are 79% water and your bones 31%. Aim for 2.5–3.5 litres daily depending on weather and sweat rate.
Alcohol and Smoking — Both weaken bones and hinder muscle growth. Consider tapering or eliminating these habits.
Sleep — Good quality sleep for 6–8 hours per night helps the body repair and rebuild. Follow a predictable schedule for best results.
Stress — Chronic stress impacts overall health. Manage it with yoga, meditation, or deep breathing exercises.
Weight — Being overweight puts additional stress on bones and muscles. A certified professional can help with a customised weight management programme if needed.
If you want to know your exact bone density or muscle mass, a DEXA scan can assess bone health and a body composition analysis (BCA) can measure muscle and fat mass. Talk to your healthcare provider to know more.
Remember - it's never too late to start working on yourself. Be regular and consistent, and your body will thank you for it.
About the author
Kanchana is a Lifestyle Consultant & Weight Management Specialist. After a Masters in Molecular Biology from the USA, she ventured into the field of Nutrition and is certified in General Nutrition, Sports Nutrition, and Weight Management. Her own successful weight loss journey inspired her to help people of all age groups and health conditions via Calorie Culture, which she founded in 2012. She is also an avid dancer, mini marathoner, and sports enthusiast. She strongly advocates sustainable lifestyle changes as a means to long-term health benefits and optimal weight.
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