Exercise and Menopause: How To Get Ahead of Bone Loss

Box of stretch bands

As women navigate menopause, a myriad of physiological changes can occur, each with its own set of challenges and opportunities. Among the various concerns that arise during menopause is the topic of bone health. 

During menopause, hormonal shifts contribute to a decline in bone density that leaves women more susceptible to developing osteoporosis and fractures. However, research shows that exercise can play a pivotal role in mitigating the adverse effects of bone loss (Zhang, 2022). 

In this article, we’ll explore the relationship between menopause, exercise and bone health. We’ll discuss the mechanisms behind bone loss and how strength training works to boost bone strength on a cellular level, and we’ll share strategies and tips for how to slow down this process of bone loss. 

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

How does menopause affect bone loss?

Menopause holds a profound influence over your body’s ability to build and maintain strong bones. The hormonal changes that occur during menopause trigger a cascade of changes that can have lasting implications. Most notable among these changes is the decline in estrogen, a hormone that has a pivotal role in bone formation and strength (Cheng, 2022). 

While bone might look solid and static, it is undergoing a constant process of breakdown and formation throughout the lifespan. Estrogen serves as a regulator of bone remodeling, meaning it contributes to the body’s ability to form new bone (Karlamangla, 2018). With the reduction of estrogen production during menopause, the balance between bone-forming and bone-resorbing cells tilts in favor of the latter. Osteoclasts, the cells responsible for breaking down bone tissue, become more active while osteoblasts, the cells responsible for bone-formation, struggle to keep pace (Khosla, 2012). The result is a gradual reduction in bone mass and architectural strength, leaving women more vulnerable to osteoporosis and fractures.

What are the best exercises to do during menopause to prevent bone loss?

There are ways to mitigate postmenopausal vulnerability to bone loss and fractures. Scientific evidence has shown that a well-designed exercise program can counteract the bone loss associated with menopause. Weight-bearing and resistance exercises, such as strength training with weights and resistance bands, can stimulate the activity of osteoblasts by providing a mechanical stimulus or stress on bones. In addition, exercise has been shown to enhance muscle strength and coordination, which in turn contributes to better balance and reduced fall risk – two critical components in preventing fractures, especially among individuals with low bone density.

However, not all exercise is created equal when it comes to bone health. The type, intensity, and frequency of exercise play essential roles in eliciting beneficial adaptations (Zhang, 2022). High-impact activities, like jumping and high-intensity resistance training, have demonstrated notable improvements in bone density (Koshy, 2022). Meanwhile, moderate-intensity activities and weight-bearing exercises deliver significant advantages without imposing excessive strain on joints. If you’ve already been diagnosed with osteoporosis, keep in mind that high-impact exercises may not be appropriate for you due to the increased risk of fractures. 

8 exercises for menopause

During and after menopause, you’re going to want to focus on incorporating weight-bearing and resistance exercises to help you build and maintain bone. Here are 8 exercises that are good for building strong bones and muscles so you can avoid significant bone loss after menopause:

1. Squats with weight

Squats are a functional exercise that strengthens many of the important large muscles in the lower body. Strengthening these muscles in this movement pattern makes it easier for you to perform daily activities such as getting up and down from a chair, going up and down stairs, and more. Adding weights to a squat increases the resistance on the body, boosting the bone-building benefits.

  • Stand upright with your feet hip-width apart and a weight in each hand.
  • Bend your elbows, holding the weights so that they're positioned just above your shoulders.
  • Then, bend your hips and knees, as though you're preparing to sit in a chair.
  • Push through your heels to return to the starting position.
  • Repeat this 10-15 times for one set. Rest for 30 seconds then repeat for 1-2 more sets.

2. Lateral step downs

Lateral step downs strengthen the muscles of the hip and leg and encourage unilateral stability and control, which is good for balance, walking, and stair negotiation. Because it is a single-leg exercise (you work one leg at a time), this puts all your bodyweight over one leg, increasing the load on the leg and boosting bone strength.

  • Stand on a step facing the handrail or a stable surface such as a countertop so that one foot is firmly on the step while the other is hovering off the edge of the step. 
  • Stand tall on the step, Both toes should be pointed forward, in the same direction you are facing.
  • Hinging at the hips, slowly bend your standing knee and lower your opposite foot towards the floor.
  • Then push through the standing heel to return to the starting position.
  • Repeat 10-15 times for one set. Rest for 30 seconds. Then repeat for 1-2 more sets.

3. Standing lunges with weights

Lunges strengthen the muscles and bones of the hips and legs, helping with everyday activities such as going up and down stairs, getting up and down from a low chair and getting up and down from the floor.

  • Begin in a split stance, with one leg in front of the other and 1-5 lb weights in each hand. 
  • Open your chest and gently activate the muscles between your shoulder blades to prevent your shoulders from rounding forward. 
  • Draw your belly in towards your spine to stabilize your core.
  • Lower your body slowly with your front leg controlling the movement and your back leg stabilizing your body. 
  • Lower until your back knee almost touches the ground and your front knee bends to a 90-degree angle.
  • Then drive through the heel to return to the starting position.
  • Repeat 10-15 times for one set. Rest for 30 seconds. Then repeat for 1-2 more sets.

4. Standing military press with weights

The military press targets the muscles of your shoulders and arms, especially the deltoids and triceps. Strengthening these muscles leads to improved ability to perform overhead activities. Using weights overhead loads not just the upper body but the whole body, making this a great bone-building exercise. 

  • Stand with your feet hip width apart and knees slightly bent. Hold a small weight in each hand. 
  • Bring your arms up so that your elbows and shoulders form 90-degree angles.
  • Slowly press your hands up toward the ceiling, straightening your elbows. Then carefully lower your arms back down to the starting position.
  • Repeat 10-15 times for one set. Rest for 30 seconds. Then repeat for 1-2 more sets.

5. Plank

The plank is an excellent full-body exercise, particularly for the core and upper body. It is weight-bearing through the hands and wrists, which helps strengthen the bones of the wrists, arms and shoulders.

  • Begin on your hands and knees, with your hands shoulder width apart and your elbows straight.
  • Reach one foot back at a time, lifting off your knees so that your full body weight is supported by your hands and feet.
  • Lengthen your spine and draw your abdominal in to engage your core as you push through your hands. You should feel like you’re pushing the floor away from you. 
  • Hold this position for 30-60 seconds. Take a 30 second break. Then repeat 1-2 more times. 

6. Quadruped alternate shoulder flexion with hip extension

Quadruped alternate shoulder flexion with hip extension (or “bird dog") enhances core strength while strengthening the bones in the wrists and arms.

  • Begin on your hands and knees, with your hands directly below your shoulders and your knees directly below your hips.
  • Reach one arm forward and the opposite leg backward, making sure to engage your core and keep a neutral spine.
  • Hold for 5-10 seconds. 
  • Then return to the starting position and repeat on the other side.
  • Repeat this for 5 times on each side.

7. Standing scapular retraction with external rotation with resistance

Standing scapular retraction with external rotation with resistance strengthens the muscles of the upper back and shoulders to improve shoulder stability and posture. Good posture can help protect your bones.

  • Grab a light resistance band and stand with your feet hip width apart.
  • Bend your elbows to 90 degrees and keep your elbow by your sides with your hands pointing straight in front of you and your thumbs up.
  • Rotate your forearms outwards, squeezing your shoulder blades together. 
  • Slowly return to the starting position.
  • Repeat 10-15 times for one set. Rest for 30 seconds. Then repeat for 1-2 more sets.

8. Circles in sand

Circles in the sand is a tai chi exercise designed to challenge single leg balance. As you do this exercise, you’re not only working on your balance but you’re also strengthening the bones of your standing leg while bringing more awareness to your ankles and the soles of your feet.

  • Begin standing with your feet parallel. 
  • Bend your knees slightly as you shift your weight  onto one leg. Pay attention to the feeling of your weight shifting. 
  • With your weight on one leg, lift your other leg slightly off the floor and make circles with your toes, like you are tracing circles in sand. 
  • Make five circles. Then reverse directions. 
  • Repeat on the other side.

There are plenty of other exercises that can help you build muscle and bone as you age and reduce your risk of fractures. Wellen’s personalized exercise program can help you get started with a progressive exercise program built specifically for you.

Regardless of how you choose to exercise, make sure you stick to a plan that is backed by science like Wellen’s. Our goal is to make mid-life less scary, to change the statistics around aging, and to empower you with the knowledge you need to proactively embrace a lifestyle that fosters strong and resilient bones. By understanding the remarkable interplay between the body, exercise and bone density, women can seize control of their bone health and march confidently into their strongest years yet.

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  1. Zhang S, Huang X, Zhao X, et al. Effect of exercise on bone mineral density among patients with osteoporosis and osteopenia: A systematic review and network meta-analysis. J Clin Nurs. 2022;31(15-16):2100-2111. doi:10.1111/jocn.16101
  2. Koshy FS, George K, Poudel P, et al. Exercise Prescription and the Minimum Dose for Bone Remodeling Needed to Prevent Osteoporosis in Postmenopausal Women: A Systematic Review. Cureus. 2022;14(6):e25993. Published 2022 Jun 16. doi:10.7759/cureus.25993
  3. Cheng CH, Chen LR, Chen KH. Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover. Int J Mol Sci. 2022;23(3):1376. Published 2022 Jan 25. doi:10.3390/ijms23031376
  4. Karlamangla AS, Burnett-Bowie SM, Crandall CJ. Bone Health During the Menopause Transition and Beyond. Obstet Gynecol Clin North Am. 2018;45(4):695-708. doi:10.1016/j.ogc.2018.07.012
  5. Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton.Trends Endocrinol Metab. 2012;23(11):576-581. doi:10.1016/j.tem.2012.03.008

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