If your joints have felt achier or stiffer than usual lately, you are not imagining it. Joint and muscle discomfort can be part of perimenopause, although it should not automatically be put down to hormonal changes. This is also an important time to think about your longer-term bone health. As oestrogen levels fall, bone loss can accelerate, particularly around and after menopause. Eating a balanced diet that provides enough calcium, vitamin D and protein can help support bone strength through this transition, especially alongside regular weight-bearing and resistance exercise.
Why oestrogen matters for bone density
Oestrogen helps keep your bones in balance. It slows the cells that break down bone tissue, so the breaking down stays in step with the building of new bone. As oestrogen falls around menopause, this balance can shift, so bone is broken down faster than it is replaced. Bone loss tends to accelerate during late perimenopause and the first few years after the final menstrual period, and some women may lose up to 20% of their bone density during the five to seven years after menopause.125
This makes perimenopause an important time to think proactively about bone health. Getting enough calcium is part of that, alongside vitamin D, adequate protein and regular weight-bearing and resistance exercise. These habits can help support bone strength before and during the period when bone loss may happen more quickly.
How much calcium you need
The recommended daily amount of calcium for adults in the UK is 700mg. You can usually reach this through food alone, without a supplement, as long as you include calcium-rich foods steadily across the day.6
Finding calcium in food, whatever your diet
Dairy is one of the easiest ways to get calcium into your day. Milk, cheese, and yoghurt all add up well, and a 200ml glass of milk gives you around 240mg of calcium, roughly a third of the daily target in one go.8
If you do not eat dairy, or only have it now and then, there are plenty of good alternatives. Calcium-fortified plant milks and bread, calcium-set tofu, and tinned fish with edible bones like sardines all pull their weight. Some dark green vegetables, kale especially, add to your calcium intake too.9
Spinach often gets a reputation as a calcium food, but most of the calcium in it never reaches your body. It is high in oxalates, which bind to calcium and block absorption. Kale does not do this to the same degree, so it is a more reliable plant-based choice.10
Vitamin D and calcium absorption
Calcium matters, but your body cannot absorb it well without enough vitamin D. Vitamin D is what lets your gut take up the calcium from your food. Getting enough of both together is what makes the whole thing work.11
In the UK, most of your vitamin D comes from sunlight on your skin, and only between late March and the end of September. Through autumn and winter the sun is not strong enough for your body to make it, so for a big chunk of the year your food and any supplements have to carry more of the load.12
A few foods do contain vitamin D: oily fish, red meat, and fortified foods like some breakfast cereals and dairy alternatives all add a little. In practice, though, it is hard to reach the recommended daily amount from food alone.13
Why a supplement is suggested through autumn and winter
Health guidance in the UK suggests all adults consider a daily 10µg vitamin D supplement through autumn and winter. This is for the general adult population, not only if your vitamin D levels are already flagged as low.14
If you get little or no sun across the whole year, for example if you are housebound or tend to keep most of your skin covered outdoors, a 10µg supplement all year round is advised. If you are not sure whether that applies to you, or you have a health condition or take regular medication, check with your GP before starting one.15
Building bone support into everyday
The real value of focusing on calcium, bone health, and perimenopause nutrition is that it works ahead of time. Adjusting how you eat during the perimenopausal years, before much bone loss has set in, gives you the best shot at carrying your bone density forward. A steady approach to calcium and vitamin D is one of the clearest nutritional levers you have for supporting your bones through perimenopause. The recommended daily amount for adults in the UK is 700mg of calcium, and that holds for most adults, including through perimenopause. Once you are in menopause (one year since your last period) it increases to 1200mg.
Spreading your calcium across meals, rather than loading it into one sitting, helps your body absorb it. Including a calcium-rich food at breakfast, lunch, and dinner is a simple way to work towards the 700mg target without having to count it precisely. Nutrition is only one part of the picture. Weight-bearing movement and resistance training give your bones the physical stimulus they need to stay strong. Walking, stair climbing and dancing all count, alongside strength exercises using weights, resistance bands or your own body weight.34