Bone loss after menopause: the five-to-seven-year window
Bone loss in women is fastest in the first 5 to 7 years after menopause, and the Bone Health and Osteoporosis Foundation says women can lose up to 20% of their bone density in that window. [1] The SWAN study found it begins earlier, about 1 year before your final period. [2] Weight-bearing and muscle-strengthening exercise are the two types BHOF names for keeping bones strong. [1]
How fast do you lose bone after menopause?
The Bone Health and Osteoporosis Foundation (BHOF) says that for women, the period when bone loss is most rapid is the first 5 to 7 years after menopause, and that women can lose up to 20% of their bone density in those years. [1] BHOF's reason is that menopause leads to lower estrogen levels, which cause bone loss. [1] ACOG puts the window slightly differently: a small amount of bone loss after age 35 is normal, but during the first 4 to 8 years after menopause women lose bone more rapidly, because of decreased estrogen. [3]
"Up to 20%" is a ceiling, not an average, and I have not found a source that gives an average for the whole BHOF window. The next section gives a measured one.
Why does bone loss matter if you cannot feel it?
BHOF describes osteoporosis as a disease in which the density and quality of bone are reduced, so bones become weaker and more brittle and the risk of fracture is greatly increased. [1] It says bone loss occurs silently and progressively, and that there are often no symptoms until the first fracture. [1] It also notes that because of midlife hormonal shifts, osteoporosis starts earlier in women than in men, and that hip fractures can cause lasting mobility problems. [1] That is the case for knowing about the window, not for worrying about it: the points below are things you can act on.
When does the loss actually start?
Earlier than your last period. The Study of Women's Health Across the Nation (SWAN) followed 862 women who were pre- or early perimenopausal at the start and later reached their final menstrual period (FMP). [2] Bone mineral density loss began about 1 year before the FMP and slowed, but did not stop, about 2 years after it. [2] The rates and amounts of loss were greatest from 1 year before through 2 years after the FMP, which the researchers called the transmenopause. [2]
Over the 10-year observation period, lumbar spine density fell by 10.6%, and 7.38% of that loss happened in the transmenopause. [2] At the femoral neck, part of the hip, the 10-year loss was 9.1%, with 5.8% in the transmenopause. [2] The study's cohort and BHOF's "up to 20%" are measuring different things, so the figures are not meant to match. What they agree on is that the loss is front-loaded around menopause. [1] [2]
What helps keep bone?
BHOF says the two types of exercise important for keeping bones strong are weight-bearing and muscle-strengthening exercise, and that balance exercises can help prevent falls. [1] ACOG says regular exercise slows bone loss, that weight-bearing exercise such as walking can help keep bones strong, that strength training strengthens muscles and bones by resisting against weight, and that balance training such as yoga and tai chi may help you avoid falls, which could lead to broken bones. [3] Both ACOG and the National Institute on Aging (NIA) say to get enough calcium and vitamin D for bone health. [3] [4] NIA notes that during the menopausal transition women may experience changes in bone density, and that it is important to eat a healthy diet, stay active and get enough calcium and vitamin D. [4]
I am not giving a calcium or vitamin D amount, and I am not recommending a supplement: how much you need depends on your diet and health, which is a conversation for your clinician. If you want a place to start with the lifting side, see the first month of lifting.
When should you have a bone density test?
That is a decision for you and your clinician. For reference, the US Preventive Services Task Force, an independent expert panel, recommended in January 2025 that women 65 or older be screened for osteoporosis, and that postmenopausal women younger than 65 who are at increased risk of osteoporotic fracture be screened too. [5] For postmenopausal women under 65, it suggests first checking for one or more risk factors, then using a clinical risk assessment tool to see who is at increased risk. [5] It gave both recommendations a grade of B. [5]
What to ask your clinician about your bones
Where am I in the window? Bring the date of your last period if you know it. BHOF and ACOG measure the fast-loss years from menopause. [1] [3]
What are my risk factors? The Task Force's approach for postmenopausal women under 65 starts with risk factors and a clinical risk assessment. [5]
Does a bone density test make sense for me now? That is your clinician's call. [5]
Is my exercise plan right for my bones? BHOF says that if you have osteoporosis or are at risk of breaking a bone, certain movements in yoga, Pilates and other exercise may need to be avoided or modified. [1]
What about hormone therapy and bone?
ACOG says systemic estrogen therapy protects against the bone loss that occurs early in menopause and helps prevent hip and spine fractures. [3] The same ACOG page lists risks of hormone therapy too, so whether it fits you is a decision for you and your clinician, weighing your whole health picture. [3]
When to talk to your clinician
Talk to your clinician if you are postmenopausal and want to know whether a bone density test or a risk assessment makes sense for you, as the Task Force describes. [5] Talk to them before you start a new exercise program if you have osteoporosis or are at risk of breaking a bone. [1] And bring up hormone therapy as a question, not an answer. [3]
Sources
- Bone Health and Osteoporosis Foundation (formerly the National Osteoporosis Foundation), Healthy Bones For Life: Clinician's Guide. The PDF is marked 2014. Retrieved 2026-10-18.
- Greendale et al., Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women's Health Across the Nation (SWAN). J Bone Miner Res 2012;27(1):111-8 (PMID 21976317). Abstract. Retrieved 2026-10-18.
- American College of Obstetricians and Gynecologists, The Menopause Years (FAQ). Last reviewed December 2025. Retrieved 2026-10-18.
- National Institute on Aging, What Is Menopause? Content reviewed October 16, 2024. Retrieved 2026-10-18.
- US Preventive Services Task Force, Osteoporosis to Prevent Fractures: Screening, final recommendation statement, January 14, 2025. Retrieved 2026-10-18. The Task Force is an independent panel; its recommendations are not an official position of the US government.
Every statement above was checked against the linked source on October 18, 2026. This article is education, not individual medical advice. Related: The first month of lifting, How much protein after 45? and How long does menopause last?