Did you know that nearly one in two women over age 50 will break a bone due to osteoporosis in her lifetime? That’s not a scare tactic—it’s a real statistic from the National Osteoporosis Foundation. And while a broken bone may not sound like a big deal, for older women, it can be life-changing. In fact, up to 24% of women over 50 who suffer a hip fracture will die within one year, often due to complications like infections or loss of mobility.
Osteoporosis isn’t just about your bones getting “a little thinner” as you age—it’s a serious health condition that deserves attention. But the good news is that it’s preventable and treatable, especially if you understand what puts you at risk and what steps you can take now to strengthen your bones moving forward.
What Is Osteoporosis?
Osteoporosis means “porous bone.” It’s a condition where bones lose density and strength, becoming brittle and more likely to break. You can’t see or feel your bones thinning, which is why many women don’t know they have it until something cracks—literally
Most breaks happen in the hip, spine, or wrist, and they often result from something minor, like tripping on a rug or lifting a heavy grocery bag. A healthy bone would bounce back. A porous one may not.
Why Women Over 50 Are at Higher Risk
Women lose bone faster than men as they age—especially after menopause. That’s because estrogen, a hormone that helps protect bones, drops significantly during this time. Without it, the body starts to break down bone more quickly than it can rebuild it.
In fact, the average woman can lose up to 20% of her bone mass in the five to seven years after menopause. If your bones weren’t in great shape before that, it’s easy to end up in the danger zone by your 60s or 70s.
Other factors that increase your risk include:
- A family history of osteoporosis
- Having a small or thin frame
- Smoking or heavy alcohol use
- Certain medications (like steroids or anti-seizure drugs)
- Lack of physical activity
- Low calcium and vitamin D intake
Signs You May Be Losing Bone Density
Unfortunately, osteoporosis doesn’t come with obvious warning signs. Most women don’t feel it happening. But some subtle clues might include:
- You’ve lost more than an inch or two in height
- Your posture is starting to curve or stoop
- You’ve had a fracture from a minor fall
- You have chronic back pain, which could indicate compression fractures in your spine
If any of this sounds familiar, it’s worth getting checked out.
Testing: How to Know Where You Stand
The best way to detect osteoporosis is with a DEXA scan (dual-energy x-ray absorptiometry). It’s quick, painless, and measures bone density, usually in the hips and spine. This test helps your doctor determine whether you have normal bone mass, osteopenia (early-stage bone loss), or osteoporosis.
Most major medical organizations—including the U.S. Preventive Services Task Force (USPSTF)—recommend that women get their first DEXA scan at age 65, or earlier if they have risk factors for bone loss. However, many functional and integrative practitioners suggest that a baseline DEXA around age 50–60 (often around menopause) is a smart move, especially for women who:
- Have entered menopause early (before age 45)
- Have a family history of osteoporosis
- Have a small frame or low body weight
- Have had previous fractures from minimal trauma
- Take medications that affect bone (e.g., corticosteroids, aromatase inhibitors, anti-seizure drugs)
- Smoke or drink heavily
- Have certain medical conditions (e.g., rheumatoid arthritis, thyroid issues, celiac disease)
Your results will include get a “T-score”, which compares your bone density to that of a healthy young adult, and a “Z-score” which compares your bone density to what’s normal for someone of your same age, sex, and body size. Practitioners use your T-score to determine where you are on the bone loss spectrum.
• Normal: -1.0 and above
• Osteopenia: Between -1.0 and -2.5
• Osteoporosis: -2.5 and below
The lower the score, the weaker your bones are—and the higher your risk for fractures. Your DEXA scan should repeated every 2 years, and if you are on osteoporosis medications, sometimes every 1 year.
What You Can Do to Protect Your Bones
If your bone density isn’t where it should be, don’t panic. There are plenty of steps you can take to strengthen your bones and reduce your risk of future breaks:
1.Hormone Replacement Therapy
If it’s done right, hormone replacement therapy (HRT) can be one of the most effective ways to not only slow bone loss—but actually rebuild bone that’s already been lost. The key is proper dosing, regular monitoring, and working with someone who truly understands the nuances of hormone balance. I strongly recommend partnering with a knowledgeable functional medicine practitioner who has extensive experience in bioidentical hormone replacement therapy (BHRT). When tailored to your individual needs, BHRT can be a powerful tool for protecting your bones—and your long-term health.
2. Focus on Calcium, Vitamin D, and other bone building nutrients
Your bone health relies on at least 15 key nutrients. Calcium and Vitamin D typically top that list. Women over 50 need 1,000 mg of calcium (including what they eat in their food) and 2,000 – 5000 IU of vitamin D daily. You can get calcium from foods like yogurt, cheese, leafy greens, and almonds. Vitamin D comes from sunlight, fortified foods, or supplements if needed. Manganese, Molybdenum, Vitamin K, and Zinc are some of the other important nutrients for bone health.
2. Stay Active with Weight-Bearing Exercise
Your bones need resistance to stay strong. Walking, dancing, hiking, yoga, and strength training are great options. Aim for 30 minutes most days of the week.
3. Cut Back on Bone Saboteurs
Smoking, excessive alcohol, and too much caffeine can all interfere with bone health. Limit alcohol to one drink a day and keep caffeine moderate. And if you smoke, quitting is one of the best gifts you can give your bones (and your entire body).
4. Discuss Medications if Needed
Depending on your DEXA results and fracture risk, your practitioner may recommend medication to slow bone loss or help rebuild bone. Options include bisphosphonates, hormone therapy, and newer drugs like Prolia or Evenity. The best approach depends on your personal health history. I recommend these only as a last resort.
Final Thoughts
Osteoporosis is a silent but serious disease—just as important as heart disease or diabetes. You may not feel your bones weakening, but the consequences of ignoring it can be life-changing.
The good news? It’s preventable. With early testing, healthy lifestyle choices, smart nutrition, regular movement, and the right support, you can stay strong, mobile, and independent for years to come. Don’t wait for a fracture to take action—start now.