Menopause changes bones in ways you can’t see or feel, so it’s important to know how to protect yourself from osteoporosis. Start by testing your knowledge with this quiz!

After menopause, a woman's bones start to lose strength.

Bone loss starts much earlier than menopause. Bones begin to break down faster than they build up after about age 35—long before age 51, the average age at which women in the US reach menopause. Estrogen loss following menopause is a primary risk factor for the bone-weakening disease osteoporosis, but it’s not the start of the weakening.

Osteoporosis symptoms can include...

Osteoporosis often is called a “silent” disease, but all of these symptoms can occur as small cracks develop in the bones of the spine over time. That can cause a stooped posture and a loss of height. While back pain has many potential causes, it can be a symptom of hairline fractures in the vertebrae due to osteoporosis.

Osteoporosis can be diagnosed with...

Bone-density testing uses an enhanced form of X-rays to determine the amount of calcium and other minerals your bones have. It's called DEXA (dual-energy X-ray absorptiometry), or sometimes DXA. The more calcium and other minerals your bones have, the stronger they are.

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Women should be screened for osteoporosis at age...

The US Preventive Services Task Force recommends screening for all women who are age 65 or older. Screening is recommended earlier for women at high risk of developing osteoporosis—those who have already broken a bone, become stooped over or had sudden back pain for no apparent reason. Learn more here.

Hormone therapy is the best drug treatment to prevent osteoporosis.

While prevention of osteoporosis is an FDA-approved indication for hormone therapy, there are other, more effective medications that now are available. So it shouldn't be the first choice for most women—especially if they don't have other menopausal symptoms. However, a woman who is already taking hormone therapy for treatment of menopausal symptoms such as hot flashes and who is at high risk for osteoporosis may not need to take additional osteoporosis-preventive medications.

Women who take hormone therapy don't need calcium and vitamin D supplements to protect their bones.

A 2014 study from the long-running Women’s Health Initiative showed that adding 1,000 milligrams (mg) daily of calcium and 400 international units (IU) of vitamin D a day to hormone therapy provided significantly more protection against hip fractures than hormones alone.

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Exercise is good for bone health even if you already have osteoporosis. But if you do, which type of exercise might be harmful?

Golf, tennis and bowling all involve bending forward or twisting at the waist, which can cause small spinal fractures in osteoporotic bones. Women who have osteoporosis do best by sticking with weight-bearing aerobic exercise—such as walking…ballroom dancing and other kinds of dancing that don’t involve twisting at the waist…strength training with free weights or a resistance band (avoiding moves that flex your spine or cause you to bend at the waist)…and slow, gentle stretching such as tai chi to improve balance and stability. The right kind of yoga can be very beneficial, as well.

Moderate alcohol consumption increases the chance that a postmenopausal woman will develop osteoporosis.

Just the opposite may be true. A study of postmenopausal women showed that having between one-half and two drinks a day was statistically linked with slower bone loss. Researchers don’t recommend starting to drink if you don’t already, and a limit of one drink a day on average is best overall for a woman’s health. But if you enjoy a glass of wine with dinner, it’s nice to know that it might help your bones stay strong. Salut!

To learn more about preventing bone loss, see the Bottom Line article “Are Your Bones as Healthy as You Think?.” If you already have osteoporosis, check out “Questions to Ask If You Have Osteoporosis.”