One of the longer-term effects of the menopause is the impact it has on our bones. Without the protective powers of oestrogen keeping our bones strong we start to lose bone density. We can become more vulnerable to complications like osteoporosis.
Indeed, researchers say that women generally experience a 10%-20% reduction in bone density due to menopause. Bone density loss slows after the first 4-8 years after the menopause, but still continues as we age.
So, if we want to remain healthy and mobile as we move through menopause and beyond, taking measures to support our bone health is a must.
HRT or supplements can help here, replacing the oestrogen that our bodies no longer make naturally to protect against bone density loss, as well as other symptoms of menopause.
And lifestyle changes can also make a difference. Research shows that regular exercise is important in protecting against osteoporosis – aim for a combination of weight-bearing, balance, and resistance exercises to keep bones strong and help avoid breaks.
Diet has a role to play too. If we want to support our bone health, we need to make sure that our bodies have the right nutrients to build new bone tissue and slow the loss of bone density.
One of the most important nutrients for bone health is vitamin D – especially when paired with calcium. And vitamin D has other benefits for our bodies during menopause too, such as alleviating vaginal dryness, supporting the immune system, and improving our mood.
In this blog post, we’ll look more closely at the role vitamin D plays in supporting our bone health as we journey through menopause and give you some tips for how to get enough.
What is vitamin D?
Vitamin D is a fat-soluble vitamin. It comes in two forms – D2, which is made by plants (mushrooms), and D3, which is made by animals, including humans.
Some foods contain vitamin D, such as oily fish, red meat, liver, and egg yolks. Mushrooms are the only plant-based food to naturally contain vitamin D, but it is also added to some breakfast cereals and oil-based spreads.
However, vitamin D is unique in that our bodies can also make it themselves. Vitamin D production is triggered by exposure to sunlight, which is why it is often nicknamed the sunshine vitamin.
Vitamin D plays many different roles in our bodies, but in this blog post we’ll focus on its relationship with our bone health.
How does vitamin D support our bones?
There are several reasons why vitamin D is integral to building and maintaining healthy bones.
Firstly, it helps our bodies to absorb and use calcium – the mineral that is one of the main building blocks of bones (and teeth). Even if we have enough calcium in our diets, we can’t use it properly unless we also have sufficient levels of vitamin D.
Vitamin D also supports the absorption of phosphorous from the gut. Like calcium, phosphorous is a mineral that is used to build bones and teeth.
Finally, vitamin D acts as a hormone and plays a role in promoting bone formation, alongside oestrogen.
Indirectly, vitamin D may also contribute to our long-term bone health because it supports muscle growth. Without enough vitamin D, our muscles weaken, and we are more likely to experience falls, which in turn can lead to bone fractures.
Vitamin D and menopause
Since vitamin D is intimately connected with bone health, and menopause is known to cause loss of bone mineral density. There has been quite a bit of research into the effects of vitamin D on bone health during and after menopause.
For example, a long running study of 72,337 postmenopausal women found that those who consumed higher levels of vitamin D had a 37% lower risk of hip fractures than those who consumed low levels, regardless of how much calcium they had in their diets.
More recently, a 2020 meta-study examined the current research into the effect of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women. The authors found that supplementing with calcium and vitamin D significantly increased bone mineral density and decreased the risk of hip fractures.
Other studies indicate that supplementing with vitamin D can help postmenopausal women to increase muscle strength and avoid falls, in turn helping to protect their bone health.
Getting enough vitamin D
So, we’ve seen that vitamin D is important to protect our bone health as we move through menopause. But how can we make sure we’re getting enough?
While there are some foods that contain vitamin D, few have high enough levels for us to meet our needs through diet alone. This is especially the case for anyone who is vegetarian or vegan, as most natural dietary sources of vitamin D are derived from animals.
The exception is mushrooms, which can contain vitamin D2, as long as they are grown in sunlight. Since many mushrooms are grown inside, you’ll need to keep an eye out for those that are specifically marked as grown in natural light or containing vitamin D.
Supermarkets increasingly make this clear on the packaging, which helps. Vegetarians and vegans can also increase the amount of vitamin D in their diets by opting for fortified breakfast cereals and other foods that have added vitamin D.
Our bodies can also make vitamin D when our skin is exposed to sunlight. While this is great news in theory, those of us who live in the UK will usually find that we don’t get enough sunlight during the winter months to meet our vitamin D needs.
Even in the summer, we need to balance the need to expose our skin to the sun for vitamin D formation against the risk of sunburn, skin damage and cancer that can come from prolonged exposure.
As a result, the NHS recommends taking a vitamin D supplement that contains 10 micrograms of vitamin D for osteoporosis prevention.
Of course, it is also a great idea to combine vitamin D supplementation with other strategies to protect your bone health. Make sure you get enough calcium and phosphorous in your diet and exercise regularly to give your bones the best chance of remaining strong through menopause and beyond.
References
What’s the menopause got to do with bone health?, The Royal Osteoporosis Society, https://theros.org.uk/blog/2021-03-22-what-s-the-menopause-got-to-do-with-bone-health/, consulted 21/07/2024
Ji, M. X., & Yu, Q. (2015). Primary osteoporosis in postmenopausal women. Chronic diseases and translational medicine, 1(1), 9–13. https://doi.org/10.1016/j.cdtm.2015.02.006
Mohebbi, R., Shojaa, M., Kohl, M., von Stengel, S., Jakob, F., Kerschan-Schindl, K., Lange, U., Peters, S., Thomasius, F., Uder, M., & Kemmler, W. (2023). Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 34(7), 1145–1178. https://doi.org/10.1007/s00198-023-06682-1
Essential nutrients your body needs for building bone, Harvard Health, https://www.health.harvard.edu/staying-healthy/essential-nutrients-your-body-needs-for-building-bone, consulted 21/07/2024
Mei, Z., Hu, H., Zou, Y., & Li, D. (2023). The role of vitamin D in menopausal women’s health. Frontiers in physiology, 14, 1211896. https://doi.org/10.3389/fphys.2023.1211896
Vitamin D, NHS, https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
Menopause and Bone Loss, Endocrine Society, https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
Laird, E., Ward, M., McSorley, E., Strain, J. J., & Wallace, J. (2010). Vitamin D and bone health: potential mechanisms. Nutrients, 2(7), 693–724. https://doi.org/10.3390/nu2070693
Feskanich, D., Willett, W. C., & Colditz, G. A. (2003). Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. The American journal of clinical nutrition, 77(2), 504–511. https://doi.org/10.1093/ajcn/77.2.504
Liu, C., , Kuang, X., , Li, K., , Guo, X., , Deng, Q., , & Li, D., (2020). Effects of combined calcium and vitamin D supplementation on osteoporosis in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Food & function, 11(12), 10817–10827. https://doi.org/10.1039/d0fo00787k
Iolascon, G., Moretti, A., de Sire, A., Calafiore, D., & Gimigliano, F. (2017). Effectiveness of Calcifediol in Improving Muscle Function in Post-Menopausal Women: A Prospective Cohort Study. Advances in therapy, 34(3), 744–752. https://doi.org/10.1007/s12325-017-0492-0
Osteoporosis – prevention, NHS, https://www.nhs.uk/conditions/osteoporosis/prevention/, consulted 21/07/2024
