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How Menopause Affects Your Bones and the Role of Calcium

by Samaira Farid,
Rose Constantine
Medically reviewed by Rose Constantine
older woman cooking a healthy meal
Bloume content relating to health, wellbeing and nutrition has been reviewed and validated by relevant medical professionals in the UK, based on UK guidelines and practices applicable at the time of publication. Recommendations in other localities may differ from those found on our site and you should always seek the guidance or advice of relevant healthcare professionals in your area.

The aches or tiredness you might put down to getting older can sometimes trace back to something quieter: the slow thinning of bone that starts to speed up around menopause. What you eat at this time of your life may carry more weight now than it did before. The shifts happening in your body at this stage change how quickly bone is lost and how well you use calcium, so calcium and bone health during menopause, and in the years after, become real nutritional priorities rather than a footnote.

Why bone density falls after menopause

Your bones are always changing. They are constantly broken down and rebuilt, a process called remodelling. Oestrogen plays a role in keeping that cycle balanced, in part by holding back how fast old bone is broken down. When oestrogen drops during menopause, bone breaks down faster than your body can rebuild it, and density falls.1

This faster loss can carry on in the years after menopause. Over time, that adds up and raises your risk of osteoporosis.3

Why osteoporosis is worth catching early

Osteoporosis is when bones become less dense and more fragile, which makes them more likely to break. The fall in oestrogen around menopause can accelerate bone loss, which is one reason osteoporosis is more common in women after menopause. However, age, genetics, certain health conditions and some medications can also affect your risk. The tricky part is that it often gives no warning signs until a bone actually breaks. By the time you notice something, a fair amount of bone loss may already have happened.4

The most common places to break a bone are the hip, spine, and wrist. If you break a bone after a minor fall or knock once you are past 40, it can sometimes point to bone loss underneath. It is worth raising with your GP rather than putting it down to bad luck.5

How much calcium you need and where to find it

In the UK, the recommended daily amount of calcium for adults is 700mg. That holds through menopause just as it did before. If you are already being treated for osteoporosis, a higher amount of around 1,000mg may be suggested, though that is a clinical decision rather than a general target. If you are under treatment, talk through your own calcium needs with your healthcare team rather than changing your intake on your own.6

Getting calcium from dairy

Dairy is one of the richest sources of calcium in food. Milk, cheese, and yoghurt all add up nicely towards that daily 700mg, and they are easy to fit across your meals.7

Calcium without dairy

If you eat plant-based or dairy-free, you can still get calcium from plenty of other foods. Green leafy vegetables like curly kale are useful. Spinach has a good reputation, but it is not a strong calcium source, because your body absorbs very little of the calcium in it. Calcium-set tofu, fortified soya drinks, and bread made with fortified flour are all dependable options.28

Other sources worth knowing about

Fish you eat with the bones in, like sardines and pilchards, give you a good hit of calcium. Almonds and other nuts add to it too, so they are an easy thing to keep in a varied diet.9

Why calcium needs vitamin D to work

Calcium on its own only does so much. Your body needs vitamin D to actually absorb the calcium from your food. Without enough vitamin D, even a calcium-rich diet works far less well, because much less of it gets absorbed.10

The recommended daily amount of vitamin D in the UK is 10 micrograms (µg). Sunlight on your skin is a main source, but between October and early March in the UK you cannot get enough from sunlight alone. The general advice is to consider a daily 10µg supplement through those months.11

There are not many foods that give you vitamin D. Oily fish like salmon and sardines provide useful amounts, and so do red meat and egg yolks. Some breakfast cereals and fat spreads have vitamin D added, which can help top up your intake, especially through the months when sunlight is in short supply.12

If anything about your bone health is on your mind, whether that is a recent fracture, a family history of osteoporosis, or doubt about your calcium or vitamin D intake, raise it at your next GP appointment.

Frequently Asked Questions

Sources

  • [1] Prevention and treatment of osteoporosis in post menopausal women

    Bone undergoes continuous remodelling, and oestrogen helps maintain bone density by inhibiting bone resorption (breakdown). When oestrogen drops during menopause, resorption speeds up relative to formation, leading to net bone loss.

  • [2] Nutritional considerations for dietitians

    Non-dairy calcium sources include kale, calcium-set tofu, fortified soya drinks, and fortified flour, while spinach is a poor source due to low calcium bioavailability caused by oxalates.

  • [3] Menopause and Bone Loss – Endocrine Society

    Bone can be lost at a rate of around 2% per year in the years following menopause.

  • [4] clevelandclinic.org

    Osteoporosis produces no symptoms until a bone breaks. The most common fracture sites are the hip, spine, and wrist.

  • [5] Menopause and Bone Loss – Endocrine Society

    A fracture from a minor fall or injury after the age of 40 can sometimes indicate underlying bone loss.

  • [6] Vitamins and minerals: Calcium – NHS

    In the UK, the recommended daily intake of calcium for adults is 700mg. For those being treated for osteoporosis, a higher intake of around 1,000mg may be recommended.

  • [7] Vitamins and minerals: Calcium – NHS

    Dairy products such as milk, cheese, and yoghurt are among the most concentrated dietary sources of calcium.

  • [8] Vitamins and minerals: Calcium – NHS

    Calcium-set tofu, fortified soya drinks, curly kale, and bread made with fortified flour are plant-based calcium sources. Spinach is not an effective calcium source because the body cannot absorb its calcium efficiently.

  • [9] Vitamins and minerals: Calcium – NHS

    Fish where the bones are eaten, such as sardines and pilchards, provide calcium. Almonds also contribute.

  • [10] nih.gov

    Vitamin D is essential for the body to absorb calcium from food. Without adequate vitamin D, absorption drops considerably.

  • [11] www.gov.uk

    In the UK, sunlight is insufficient to maintain adequate vitamin D levels between October and early March. The government advises that everyone should consider taking a daily 10µg supplement during these months.

  • [12] mayoclinic.com

    Dietary sources of vitamin D include oily fish such as salmon and sardines, red meat, and egg yolks. Some breakfast cereals and fat spreads are fortified with vitamin D.