Have you seen the commercial where a cute little dog talks about a bone-building drug her owner takes? It’s a clever play on the dogs-and-bones connection, but there’s nothing cute about what the drug is supposed to prevent or treat—osteoporosis.  

Osteoporosis Symptoms: Why Bone Loss Often Goes Unnoticed

The name tells the story: Osteo means “bones” and porosis means “porous” or “thinning.” Women with osteoporosis have brittle bones that can break easily.  

Normal bone tissue has a structural framework that makes the bone strong. It’s a matrix made of collagen with minerals woven in, like calcium, magnesium, and phosphate. But just like Jenga blocks being pulled out slowly, osteoporosis removes the support bit by bit from the once-strong bone matrix. The disease is silent and progressive. So, you feel fine, even though your body is breaking down bone faster than it can rebuild it.

The sneakiest thing about osteoporosis is that a broken bone may be your first symptom. You trip, reach out to catch yourself as you fall, and break your wrist or collarbone. Or you fall and break a leg or hip. As osteoporosis advances, bones get so fragile that just bending over, lifting something, or simply coughing or sneezing can cause a fracture.

Why Are Women More Likely to Develop Osteoporosis After 50?

You probably already know that more women get osteoporosis than men. In people over 50, almost 19% of women have osteoporosis, while only about 4% of men do. Part of the reason for this gap is that women have lower peak bone mass and smaller bones than men.

Have you reached your 50^th birthday yet? In the United States, more than half of women over 50 already have low bone mass in either their thigh bone or in their lower back. And that’s a problem, because if you have low bone mass, you’re raising your risk of developing osteoporosis.

Things besides age can affect your bone density, like your body size. If you’re a small-boned, slender woman, you’re at greater risk because you have less bone than a larger woman, so you can’t afford to lose any of that.  

There are also differences in risk based on your heritage. If you’re White or Asian, your risk for developing osteoporosis is higher than if you’re Black or Hispanic, but women of any background can develop the disease. And your habits can take a toll on your bones—things like tobacco or alcohol, nutrient deficiencies, and a sedentary lifestyle.

How Does Estrogen Loss During Menopause Affect Bone Density?

Hormones play a crucial role in bone metabolism. Throughout life, estrogen is like a bone coach, directing cells called osteoclasts and osteoblasts to constantly “remodel” your bones. Osteoclasts break down old bone tissue, and osteoblasts build new bone tissue. (Think osteoclasts crumble, osteoblasts build.)

Estrogen helps put the brakes on how much bone is crumbled by osteoclasts. And estrogen helps osteoblasts build enough new bone cells to keep your skeleton strong.

When estrogen levels fluctuate and often drop during perimenopause and menopause, the bone coach slacks off. The protective effect estrogen had on bone building ebbs away over time. So, bone loss accelerates, and your bones get weaker and more brittle.

And get this: While rapid bone loss starts in late perimenopause, you can lose up to 20% of your bone density in the 5 to 7 years after hitting menopause. So, 12 months after your last menstrual period, that 5-to-7-year period begins.

Is Osteoporosis a Serious Health Risk for Women?

Um, yeah—it can be very serious. In one study, having osteoporosis was associated with a 47% higher risk of death from any cause.  

One reason for that dismal statistic is hip fractures, which are common in women with osteoporosis. Only one in four people who break a hip makes a full recovery. And in people 65 and older, one in five dies within a year of the hip fracture. Not to mention the possible need for a cane or walker, which means reduced mobility and a lower quality of life.

The Menopause Society outlines other threats to menopausal women from osteoporosis: pain, poor balance, loss of height, and a “hunched over” disfigurement. In advanced osteoporosis, the bone marrow (in the center of bones) makes fewer blood cells, so you can have fatigue and poor immune function.

But you’re not powerless against bone decline. Let’s talk about two things you can do to protect your bones: walking and balancing your hormones.

Can Walking Help Improve Bone Density After Menopause?

Everyone knows exercise is good for bone health. But it’s specifically weight-bearing exercise like walking, jogging, hiking, and jumping rope, that stimulates bone building. You can also work your muscles against a force to strengthen bones by lifting weights or using resistance bands.

What other movement can you do where your feet move around while bearing the weight of your body and pushing and pulling on your bones? How about tennis, pickleball, or dancing?

But what if you don’t have sports equipment or access to tennis courts or a gym? You can WALK. Research in menopausal women shows that walking can make a big difference by enhancing bone remodeling.

In a small, short-term study, walking was linked to favorable changes in bone markers in menopausal women. 

Walking May Support Bone Health Through Your Gut Microbiome

There’s another layer to walking that may help your bones, and it involves the gut microbiome. Yep, that means the bacteria in your colon.  

There seems to be a positive correlation between the amount of intestinal Lachnospiraceae bacteria and bone mineral density. So having an abundance of this bacterial type may be associated with stronger bones.  

You’re probably wondering, “How in the world would you go about getting more Lachnospiraceae bacteria?” Glad you asked. You can walk! Studies show that exercise can lead to an increase in these particular intestinal bacteria.

Score another win for walking! It helps build bone density in two ways—through stressing your bones and improving your gut microbiome.  

Walking and Brain Health: Can Daily Steps Lower Dementia Risk?

Not only is walking easy and free; it also does double duty—protecting both your bones and your brain.

Researchers wanted to see if daily step count and walking speed affected a person’s dementia risk, so they studied more than 78,000 men and women ages 40 to 79. Turns out that taking more steps and walking faster are linked to a lower risk of developing dementia:

• 9800 steps per day is associated with 51% lower dementia risk

• 3800 steps per day is associated with 25% lower dementia risk

These are pretty amazing results!

The health benefits of walking for midlife women just keep adding up. And the fun thing is, you can keep track of how you’re doing with a step counter. There are phone apps, watches, and rings that count steps for you. If you prefer a non-tech solution, you can order a simple step counter to attach to your belt loop.

Estrogen Therapy Helps Support Bone Health After Menopause

In perimenopause and menopause, walking is a must-have tool in your wellness toolbox, but estradiol may be a vital therapy too.  

Replenishing your estrogen with bioidentical hormone replacement therapy (BHRT)has been studied for its role in slowing bone loss after menopause. Estrogen has been shown to help turn on the mechanisms that build bone while reining in bone breakdown. Replacing estrogen may also restore the hormone’s protective effect on brain cells.

Don’t become the next menopausal woman with a broken bone! Ask your healthcare provider about bone density screening and which options, including activity, nutrition, and hormone therapy, fit your health history. And treat yourself to a long walk every day.