Key Takeaways
- Osteoporosis is one of the most common –and often most overlooked– medical conditions women face before, during, and after menopause.
- Early clues of osteoporosis or bone loss include height loss, changes in posture and/or back pain.
- With early awareness, screening, and timely intervention, this condition is not only manageable but profoundly preventable.
- Ways to manage osteoporosis and rebuild bone density include strength training, eating food that support bone health, physiotherapy, HRT and medication.
Do you often experience a stiff back or what is described as an “ageing ache”? If you are in your forties, fifties or sixties, this is the time to pay attention.
Those symptoms may be signs that point to osteoporosis, a condition that causes bones to become weak or brittle and increases your risk of fractures. In Singapore, it is extremely common for midlife women to experience bone loss or osteoporosis, and this risk dramatically increases during menopause.
Understanding your bone health is one of the most powerful ways to care for your future self. Read on to understand how menopause causes osteoporosis, signs you are going through bone loss, and ways to manage this condition to the point of rebuilding bone density.
Why Osteoporosis Matters More Than Most Women Realise
Did you know that one in three women will experience osteoporotic fractures in their lifetime? This risk increases sharply after menopause due to accelerated bone loss and can happen in smallest ways – a slip, misstep or even bending awkwardly. Hip fractures are particularly serious – between 21 and 30% of women do not survive the first year following a hip fracture.
Bone loss often starts about a year before menopause and peaks over the next three to four years. In fact, women can lose up to 20% of their bone density in the five to seven years around this stage of life. About one in four women are “fast bone losers,” losing bone even more quickly.
In Singapore, roughly 8% of midlife women already have osteoporosis. Women account for two-thirds of all hip fractures, and silent spine fractures are common, often mistaken for normal ageing aches.
How Does Menopause Cause Osteoporosis?
Oestrogen protects bone throughout your reproductive years – it slows bone breakdown and keeps bone turnover balanced.
During perimenopause, oestrogen levels fluctuate unpredictably. By menopause, levels fall dramatically and bone loss accelerates.
Research shows that women can lose up to 20% of their bone density in the first 5–7 years after menopause, a period sometimes called the “bone vulnerability window”. This leads to faster bone thinning, a weaker vertebrae and hips and higher risk of fractures even from low-impact movements.
Prevention must begin before major symptoms appear.
How Do I Know If I Have Osteoporosis or Bone Density Loss?
The signs of osteoporosis are usually subtle:
- Height loss
- A stooped or rounded upper back
- Sudden, unexplained back pain
- A fracture from a minor fall
- A family history of fragility fractures
These symptoms must be assessed by a doctor, who will confirm an osteoporosis diagnosis through a DEXA scan.
A DEXA scan detects osteoporosis by measuring the density of your bones. It uses a very low dose of X-rays to compare the amount of bone mineral in your bones to that of a healthy young adult. A DEXA scan can detect bone loss early, identify your most vulnerable areas, estimate fracture risk, and track how your body responds to treatment over time.
At Prologue, we recommend DEXA for:
- Women 65 and above
- Women in postmenopause especially with risk factors for fractures
- Sentary lifestyle
- Family history of osteoporosis and fragility fracture
- Prolonged immobilisation
- Prolonged steroid use
- Recurrent falls
- Women experiencing early menopause (less than 45 years old)
- Women with a family history of fractures
How Can I Manage Bone Loss from Menopause?
Proper bone health requires a multi-layered approach.
Nutrition Tailored for Bone Strength
These nutrition plans must be tailored to support bone repair and metabolic stability. Ideally, they should include recommendations for:
- Food sources rich in calcium and vitamin D
- Adequate protein for bone rebuilding
InBody Testing for Muscle, Fat and Metabolic Insight
InBody analysis gives us a deeper view of your metabolic and musculoskeletal health. It measures your muscle distribution, visceral fat, inflammation patterns, hydration, and overall body composition with impressive detail.
This allows us to design nutrition, movement, and treatment plans that are truly personalised, helping you build strength, improve balance, and support bone health from the inside out.
Physiotherapy to Restore Strength and Stability
Our bone is made of living tissue that rises to the demands we place on it. As we grow older, and especially through menopause, we naturally become less physically active; without regular load, bone begins to weaken, lose density, and grow more fragile.
Weight-bearing exercises, resistance training, balance practices become increasingly essential with age – they give your body the stimulus it needs to stay healthily resilient. Movements like squats, lunges, free weights, and resistance bands activate bone-building cells helping restore bone density and support balance, posture, and stability.
Working with a professional experienced in bone conditions and menopause will go a long way in improving your bone health so you not just prevent/manage osteoporosis but feel better in your day to day.
Our clinical physiotherapists can help with:
- Posture correction
- Strengthening the spine and hips
- Improving balance
- Preventing falls
- Reducing chronic pain
Medical therapy
Bisphosphonates are usually the first line for the treatment of osteoporosis. Bisphosphonates inhibit bone remodelling, and all oral bisphosphonates have been shown in randomised trials to reduce the risk of fractures.
Hormone Replacement Therapy (HRT) is another medical intervention that can be useful for preventing bone loss after menopause. This can be considered for those who are experiencing early menopause and have other menopause symptoms like hot flashes, and have low risk for complications.
When started within the “window of opportunity” (typically within 10 years of menopause before the age of 60), HRT is associated with:
- Better metabolic stability
- Reduced fracture risk
- Improved mood, sleep and cognitive clarity
- A potential reduction in long-term dementia risk
However, HRT comes with risks such as blood clots and breast cancer, so always check with your doctor to assess suitability and how to start HRT safely.
Can You Rebuild Bone Density After Menopause?
Absolutely. Bone is living tissue. With the right interventions, it responds and rebuilds.
Apart from the suggestions above, you can also consider taking supplements. Supplements such as calcium, magnesium, Vitamin D and Vitamin K2 play essential roles in bone renewal. The right combination of supplements ensures your bones have the right materials they need to repair and stay strong.
For women with advanced bone loss or high fracture risk, medications can help. Anti-resorptive treatments slow bone breakdown, while anabolic therapies stimulate the body to build new bone.
And of course, regular DEXA monitoring allows you to track changes in bone density over time. Clear data paves the way for optimal treatment plans, ensuring your journey is guided with care.
Your Next Season Deserves Strength From Within
At Prologue, we support the whole woman, not just her symptoms. By providing a safe space for feminine wellness, we help mothers and daughters step confidently into the seasons ahead.
It’s time to protect the foundation of your long-term health – your bones. Schedule a consultation today.