9 Tips For Healthy Bones After Menopause

I’m keen to be walking and exercising and living an active life for many years after menopause. Menopause is the time when our ovaries stop making estrogen, and our menstrual cycle ceases, around about the age of 51 on average. Estrogen is one of the factors that helps women to maintain bone health, so we must be careful to support our bones in other ways post menopause.


HRT is often recommended to women after menopause to maintain healthy bones. However there are a few things to consider before making this choice, such as ensuring your diet and lifestyle are optimised for great bone health.


Did you know that our bones are in a constant state of being broken down and repaired? Older bone is resorbed and new bone is made to take it’s place to keep bones strong throughout our life time. The quality of the bone is dependant on the nutrients available to make new bone. It should be no surprise that the nutrients available for bone health are dependant on what you are eating.


These are my tips for maintaining healthy bones into old age:


1. Enjoy a wide range of foods containing bone building nutrients


We all know that dairy products such as milk, cheese and yoghurt contain calcium as this was one of the main nutritional messages that was drummed into us during childhood. Unfortunately many people are unable to eat dairy for a range of reasons, so it’s helpful to know what other foods contain calcium, and invite these foods to be regulars on your dinner plate.


Calcium containing foods include salmon and sardines with small bones, almonds, broccoli, mustard cabbage, bok choy and tofu. Herbs and spices to add more calcium to your meals include basil, celery seed, fennel seed, thyme, sage, rosemary, dill, cinnamon and nettle.


It’s also important to eat a wide range of fruits and vegetables because there are many other nutrients such as boron, vitamin K, zinc, magnesium, manganese that need to be available for calcium to be absorbed into bone. The best way to ensure that you’re getting a wide range of nutrients is to have variety in your diet.


2. Take a good quality calcium supplement at the right time


Not all calcium supplements are equal. Please check with your naturopath or pharmacist to make sure the supplement you choose contains not just calcium, but a range of other bone supporting minerals. And remember that not everyone benefits from taking a supplement.


Supplements such as iron tablets should not be taken with the same meals as calcium as these can compete for absorption. Thyroid medications should also be taken several hours away from calcium supplements to improve absorption of calcium.


I usually recommend taking nutrients for bone health before bed, as your bones are being replenished while you sleep.


3. Optimise digestion for absorption of calcium and other nutrients


If you experience regular digestive problems such as diarrhoea, bloating, SIBO, coeliac disease, IBS, IBD or reflux, this can be affecting your ability to absorb nutrients from your food (and your supplements).


After menopause I highly recommend that you seek assistance for any digestive health conditions, to make sure you’re maximising nutrient absorption. Nutrients aren’t just needed for bones. We need our nutrients for energy; healthy eyes, skin and nails; and longevity.


Our gut microbiome also assists our intake of essential nutrients because the bacteria that live in our large bowel make nutrients such as vitamin K, from the fibres that we can’t digest. Beneficial gut bacteria can be supported via diet changes to increase prebiotic foods.


Dysbiosis might be suspected if you have regular bouts of bloating and constipation and this can lead to less than ideal nutrient status and have a negative effect on bone health.


4. Medications can affect calcium absorption


There are quite a few medications that can interfere with calcium absorption. It’s good to know if you will need to supplement bone health to counter any medications that you have to take. The information sheet that comes with your medication will tell you if it interferes with bone health and at what dosage.


The most commonly taken medications that interfere with digestion and absorption are proton pump inhibitors that women take for relief from reflux and heart burn. Reflux medications reduce stomach acid levels and compromise digestive function.


5. Be aware of foods that bind calcium


Foods that contain oxalates can bind calcium and make it unavailable for absorption and use in the bones. Oxalates are found in a range of foods such as blackberries, rhubarb, sweet potato, black tea, spinach, beetroot greens, carrots and almonds.


These are common healthy foods that make up a large percentage of many women’s diets. I recommend slowly cutting back on high oxalate foods and replacing them in some meals with the many foods that don’t contain oxalates such as broccoli, celery, lettuce, cabbage, fennel, cauliflower.


Once again, seek professional advice if you need to and remember that eating a wide variety of fresh foods in your diet is the key to maximising the nutrients absorbed into your body.


6. Enjoy an alkaline diet


Another food tip is to aim for a balance of alkaline rather than acidic foods. It’s important for our health to maintain blood pH within a narrow healthy range. If we eat too many acidic foods such as meat and grains, calcium can be extracted from bones to act as a buffering agent against an acidic diet.


An alkaline diet contains many plant based foods. If you don’t enjoy many vegetables, please read my blog about how to eat more plants.


7. Reduce alcohol and smoking


You guessed it! A 2020 report linked smoking with worse bone health after menopause and an increased risk of hip fracture. Smoking is also a risk factor for cancers and other diseases of ageing, so please quit if you can.


The same report was not as clear about the affect of alcohol on bone health and seems to suggest that alcohol in moderation may even play a protective role. Moderate alcohol consumption is considered 2 or less glasses on 2 to 4 days per week.


8. Exercise


Resistance exercise using weights can improve bone density and muscle strength as we age. The exercise should be at a level that is greater than usually experienced during daily activities, such as a work out at a gym using weights, exercise bands or your own body weight.


Gentle exercise is also beneficial because when we are moving it improves circulation of blood and nutrients to the extremities. Any exercise you enjoy that gets you moving is good for your circulation and ultimately your bone health.


9. Get out in the sunshine!


Research suggests that up to 40% of Australian women are deficient in Vitamin D, which is a molecule that affects the way calcium is absorbed, transported and used in the body. Vitamin D is important in so many aspects of our health and healthy bones is just another example.


The best way to get your vitamin D is from exposure to the sun. Try to get out in the sunshine for at least 20 to 30 minutes every day.


We don’t make enough vitamin D from the sun in winter or spring because of the angle of the sun in Australia, so I often recommend that women who tend to be low in vitamin D will benefit from taking a supplement during these seasons.


Other naturopathic support for bone health:


I support menopausal women to take a holistic and long term approach to their health. I recommend slow and sustainable diet and lifestyle changes after menopause to improve longevity and bone health.


Supplements can often be part of the picture, especially in the short term, however over the long term there is no better way to age well than making sure your diet and digestive function supports your health goals.


Herbal medicine can play a part by circulating nutrients, supporting healthy capillaries and making nutrients available to bones. If you are approaching menopause then I invite you to have a consultation with me to find out how I can help you to maintain your ongoing health and vitality.


Simone 🙂

Doctor taking patient notes

A diagnosis of PCOS and IBS – a wholistic approach can help

Getting to the cause of PCOS and IBS with a holistic approach

29-year-old Sonya* came to see me for help with Polycystic Ovarian Syndrome (PCOS) and Irritable Bowel Syndrome (IBS) which had both been diagnosed by her GPs many years ago. She had been taking different medications over the years for both of these conditions, but had not seen much progress or relief in her symptoms. They were also causing her to experience significant unpleasant side effects and so had to keep ceasing and changing her medications.

Anxiety, fatigue and insomnia

Ever since being diagnosed with PCOS and IBS, Sonya had been experiencing daily anxiety, fatigue and insomnia, which are commonly seen in people who have both of these conditions. She was understandably overwhelmed and exhausted, but hopeful that a more wholistic approach to her conditions could offer some relief and a deeper look into the underlying causes of her symptoms.

While gathering all the background to Sonya’s health and medical history, it became apparent that Sonya had in fact been experiencing digestive issues such as bloating, alternating constipation and diarrhoea, cramping and excessive flatulence, since she was a young teenager. These digestive symptoms had become considerably worse after a bout of food poisoning when she was travelling overseas.

The pill masked the symptoms of PCOS

Sonya had taken the oral contraceptive pill (OCP) from the age of 14 until she was 25 years old. She became very distressed when she stopped taking the OCP and her periods didn’t come regularly. In fact, she was lucky to have 8 in a year. She also developed facial and body acne. Along with everything else, this was very distressing.

What tests to do?

Sonya had some baseline testing done with her GP for hormones, inflammatory markers and iron studies. Due to her history, I ordered a comprehensive DNA stool test, called the GI Map, to assess the levels of good and bad gut microbes that may be influencing her current symptoms. Also, I was looking to rule out any involvement of parasites, pathogenic bacteria, worms, yeast and fungi that may have been causing her digestive distress.

While awaiting the results, Sonya followed an initial naturopathic treatment plan. This included herbal medicines and nutritional support to reduce her daily digestive symptoms, as well as to improve her sleep quality and reduce her anxiety.

Stool testing revealed that Sonya had significantly low levels of ‘good’ bacteria in her gut microbiome associated with insulin sensitivity (a key feature of PCOS), as well as overgrowths of bacteria that are associated with inflammation.

Balancing the microbiome

Sonya was placed on an individualised treatment protocol with specific probiotic, prebiotic & anti-inflammatory treatments to repopulate the levels of good gut bacteria, and a low FODMAP diet temporarily whilst healing her gut. Sonya was educated on the importance of eventually reintroducing FODMAP foods back into her diet once her gut microbiome and digestive function had improved, as it is only a short-term strategy for symptomatic relief while dealing with the more significant underlying issues.

Sonya’s blood tests with her GP showed high insulin resistance, high testosterone and high inflammatory markers. These sorts of results are common in PCOS, although are not always present in every case, thus the importance of testing rather than assuming.

She was prescribed targeted herbal medicines along with diet and lifestyle support to assist in improving her insulin sensitivity and reducing inflammation, with the aim to see her periods become regular and reduce her acne breakouts.

I met with Sonya one month after starting her comprehensive plan. She was happy to report that her digestive symptoms had significantly improved – she was having regular and easy to pass bowel motions and was not experiencing bloating or cramping. Sonya was feeling much more energetic, her mood had improved and she was sleeping through the night. Her period was running late but her acne had calmed down slightly. We discussed the importance of sticking to our treatment plan long-term as these symptoms of PCOS need time to see improvement.

The effort was worth it

Sonya continued her treatment plan for the next 12 months and was happy to report that within 6 months she had started to have noticeably regular periods that were pain free, and her skin had dramatically improved with no more breaking out.

Sonya continues to take gut-healing supplements and an individualised herbal medicine to this day, to ensure she is in the best state of health possible.

* Name has been changed

By Steven Judge – Clinical Naturopath, Nutritional Medicine, Western Herbal Medicine