Medically Reviewed by Samantha M. Dunham, MD on December 1, 2024 | Written by Progyny Editorial Team
No matter your stage in life—whether post-family building, approaching perimenopause, in the menopause transition, or already postmenopausal— investing in your musculoskeletal health (the overall well-being of your muscles, bones, joints, and connective tissues) is essential.
As you age, hormonal changes can increase your risk of musculoskeletal disorders such as osteoporosis, a condition that can cause your bones to become weak, brittle due to low bone density. However, you can take many preventative steps to preserve your musculoskeletal health. Exercise, lifestyle changes, and awareness of certain nutrients, can help you maintain strong bones and muscles to support mobility, balance, and overall wellness throughout your life.
This guide will walk you through the key strategies you can use now to support your bone density and muscle strength.
Why Musculoskeletal Health Matters Before Menopause
Whether menopause is years or decades away, it’s important to understand the significant hormonal changes that impact your bone density as you grow closer. Most bone loss occurs around the time of menopause in the few years leading up to the final menses and in the few years following.
Estrogen, a reproductive hormone, protects bone density and prevents bones from becoming weaker. However, during menopause, your estrogen levels decrease, increasing your risk of developing osteoporosis. Your bones develop until you are around 25 and then stay basically the same until the few years around menopause when rapid bone loss can occur.
Although your chances of developing osteoporosis increase as you age, or if you have a family history of it, taking a proactive approach before menopause can reduce your risks and help build a strong foundation for your later years. Think of it as an investment in lifelong wellness!
Nutritional Strategies for Strong Bones and Muscles
A well-balanced diet full of essential vitamins and nutrients can improve your health significantly as you age. Calcium, vitamin D, and protein are particularly important to keep in mind.
Calcium and vitamin D
You may have heard that milk is good for your bones because it contains calcium, which is true. Bones contain your body’s reservoir of calcium, one of the cornerstone nutrients for bone health. It is necessary to build strong, healthy bones. However, calcium is not a one-woman show. Without vitamin D, your body cannot effectively absorb calcium. Aim to include enough of these nutrients in your diet for optimal bone health. The recommended daily intake for calcium varies by age:
- Adults 19-50 years: 1,000 mg per day
- Adults 51 and over: 1,200 mg per day
Our bodies can only absorb around 500 mg of calcium at once, so it’s important to divide the calcium containing food and beverages over the course of the day. Dairy or food fortified with calcium provide some of the best sources of calcium. For example, 1 cup of Greek yogurt has 450 mg and 1 cup of raw kale has 90 mg of calcium. Milk, cheese, broccoli, bok choy, tofu, and fortified cereals are other options.
Vitamin D3 recommendations:
- Adults 19-70 years: 15 mcg (600 IU) per day
Although over-the-counter supplements are available, your diet is the best place to meet your daily intake needs. Here are some vitamin D-rich foods: milk, plant-based milk, fatty fish, egg yolks, mushrooms, and fortified cereals. Consider supplements, if deficient.
Protein
Protein is a building block for strong bones and muscles and helps maintain bone health. A daily supply of protein is necessary to maintain peak bone mass. In fact, increased protein intake later in life may decrease your risk of bone fractures. The recommended daily intake for healthy adults is 0.36 g of protein per pound of body weight. Here are some ideas for protein-rich foods to incorporate into your diet:
- Lean proteins: Seafood, poultry, lean meats, and eggs
- Plant-based proteins: Beans, soy products, nuts, and seeds
Exercise to Strengthen Bones and Muscles
Regular physical activity is one of the best ways to strengthen bones and build muscle. Specifically, to reduce your risk for musculoskeletal disorders, prioritize strength training and weight-bearing exercises.
Resistance training places stress on your bones—but it’s a good type of stress. The weight-bearing activities stimulate your bone-forming cells which encourage your bones to remodel and grow stronger. Increasing your resistance over time may help increase your bone density and reduce your risk of bone fractures as you age.
Use free weights, weight machines, medicine balls, and resistance bands during resistance exercises for the best results. Aim for two or more strength training sessions per week. The Centers for Disease Control and Prevention (CDC) recommends you work all major muscle groups such as legs, hips, back, abdomen, chest, shoulders, and arms. You can do compound movements that use multiple muscle groups at a time like the following:
- Chest press
- Bent-over row
- Push-up
- Squat
- Deadlift
- Lunges
Additionally, include exercises to improve your flexibility and balance. Flexibility and balance exercises improve your range of motion to support muscle and joint health, such as:
- Pilates
- Yoga
- Foam rolling
- Dynamic stretches
As always, work with a professional personal trainer and/or consult with your provider when starting a new exercise regimen, or if you’re experiencing new pain with it.
Lifestyle Habits
Protecting your musculoskeletal health also means avoiding habits that can weaken bones and muscles. Here are some key lifestyle modifications to consider:
- Limit caffeine: Too much caffeine can increase calcium loss and worsen hot flashes and night sweats. Eliminate it or keep consumption to less than 400mg per day to avoid these negative effects. This is about 13.5 ounces.
- Limit or avoid alcohol: Excessive alcohol intake over your lifespan can compromise your bone health. While there are few guidelines on how much alcohol is too much, the CDC recommends women have no more than one drink per day.
- Quit smoking: Smoking can decrease your bone density because it hinders your body’s ability to absorb calcium and increases your risk of developing osteoporosis.
- Maintain a healthy BMI: The ideal body mass index (BMI) should be between 18.5 and 24.9. A BMI below 18.5 is a risk factor for osteoporosis. While obesity increases bone mass, this does not correlate to a decreased risk of fractures. In fact, individuals who are obese are more likely to fall and break a bone. Eating a well-balanced diet and exercising regularly can help you maintain a healthy BMI.
Regular Check-Ups and Screenings
Routine check-ups and bone density screenings are important in staying on top of your musculoskeletal health. Talk to your physician about screening tests like Dual-energy X-ray Absorptiometry (DEXA) scans to assess your bone density. Remember, an ounce of prevention is worth a pound of cure. Identifying issues early on can make a huge impact on your long-term health.