Bone health is one of the most important — and most overlooked — aspects of long‑term wellbeing. In Australia, osteoporosis and low bone density affect millions of adults, yet many people only discover the issue after a preventable fracture. For women, the years around perimenopause and post‑menopause are particularly critical, as hormonal changes accelerate bone loss.
The good news? You can build stronger bones long before menopause, and there is plenty you can do during and after the transition to slow decline and support healthier ageing.
This guide explores how bone density changes with age, why women are more affected than men, and the practical steps Australians, especially those in Perth, can take to protect their skeletal health.
Understanding Bone Density Decline in Women
The Role of Oestrogen
Oestrogen plays a major role in maintaining bone strength. As levels fall during perimenopause and menopause, bone breakdown speeds up.
Key statistics:
- Women can lose up to 10% of their bone mass in the first five years after menopause.
- Overall, women lose 20–30% of their bone density in the decades following menopause.
- Men also lose bone with age, but at a slower rate; typically 1% per year from their mid‑50s, compared with 2–3% per year for women during early post‑menopause.
This difference explains why 80% of osteoporosis cases in Australia occur in women.
Why Early Action Matters: “Banking” Bone Before Menopause
Peak bone mass is usually reached by the late 20s. From the early 30s, bone density naturally declines, slowly at first, then more rapidly during perimenopause.
Building as much bone as possible before this stage creates a “bone bank” that offers protection later in life.
What You Can Do in Your 20s, 30s and Early 40s
These are the prime years for building and maintaining strong bone:
Prioritise resistance training
Strength training stimulates osteoblasts, the cells that build bone. Squats, lunges, deadlifts, presses and weighted carries are especially effective.
Include impact and weight‑bearing exercise
Running, hiking, tennis, dancing and stair climbing all help strengthen the hips and spine.
Ensure adequate calcium and vitamin D
In Australia, one in four adults is vitamin D deficient, especially during winter or for those who work indoors. Perth’s sunny climate helps, but sunscreen use and indoor lifestyles still reduce natural vitamin D production.
Support muscle mass
Muscle and bone health are closely linked. Maintaining strong, functional muscle reduces fall risk later in life.
Consider creatine for training support
Creatine can enhance strength and training quality, indirectly supporting bone‑building stimulus.
What Happens During Perimenopause and Post‑Menopause
Perimenopause often begins in the mid‑40s, with menopause occurring around age 51 on average in Australia.
During this transition:
- Bone loss accelerates sharply.
- The spine and hips are most affected.
- Muscle mass also declines, increasing fall risk.
This is the period when many women first notice changes in posture, joint discomfort or
reduced strength, all of which can be linked to bone and muscle changes.
How to Reduce Bone Loss During This Stage
Even though bone loss speeds up, there is still a great deal you can do to slow the decline, and in some cases, even increase bone density.
1. Strength Training Becomes Essential
Resistance training is the most powerful lifestyle tool for maintaining bone density during menopause. Studies show it can reduce bone loss by up to 50% in post‑menopausal women.
2. Add Impact or Power‑Based Movements
Low‑to‑moderate impact activities, such as step‑ups, skipping, hopping, or light jogging, help stimulate bone formation. These should be tailored to individual comfort and fitness levels.
3. Maintain Adequate Protein Intake
Protein supports muscle mass, which in turn supports bone strength and stability.
4. Ensure Sufficient Calcium, Vitamin D and Magnesium
These nutrients work together to support bone structure and mineralisation.
5. Prioritise Balance and Mobility Training
Falls are a major cause of fractures. Improving balance, coordination and lower‑body
strength significantly reduces risk.
6. Consider a DEXA Scan
A DEXA (dual‑energy X‑ray absorptiometry) scan is the gold standard for measuring bone density.
In Perth, DEXA scans are widely available through radiology clinics (with a medical referral) and at almost double the cost of Perth DEXA scan where we are making DEXA more accessible and affordable, so you can measure 2-3 times per year and measure your progress.
A DEXA scan can:
- Identify early bone loss
- Track changes over time
- Help guide personalised exercise and lifestyle strategies
The Reality of Fractures in Australia
Bone fractures are far more common and more preventable than many people realise.
Australian statistics:
- More than 173,000 fractures occur each year due to osteoporosis or low bone density.
- That’s one fracture every three minutes.
- Hip fractures are particularly serious: up to 20% of people die within a year, and many never regain full independence.
- Women are twice as likely as men to experience an osteoporotic fracture.
- However, men have higher mortality rates after major fractures.
The most important point: many of these fractures are preventable with early screening, strength training, adequate nutrition and fall‑prevention strategies.
Men vs Women: A Quick Comparison
|
Factor
|
Women
|
Men
|
|---|---|---|
|
Peak bone mass
|
Lower than men
|
Higher
|
|
Rate of decline
|
Rapid drop during peri‑ and post‑menopause
|
Slow, steady decline
|
|
Osteoporosis prevalence
|
~80% of cases
|
~20%
|
|
Fracture risk
|
Higher overall
|
Lower overall but higher mortality after hip fracture
|
|
Hormonal driver
|
Oestrogen decline
|
Gradual testosterone decline
|
Final Thoughts
Bone health is not something to think about only after menopause, it’s a lifelong investment. Building strong bones early creates a protective buffer, and taking targeted action during perimenopause and post‑menopause can dramatically slow bone loss.
For women in Perth and across Australia, the combination of resistance training, impact exercise, good nutrition, vitamin D awareness, and regular DEXA monitoring offers a powerful toolkit for lifelong skeletal strength