A recent study out of UCLA reveals that most of the bone loss that occurs with menopause happens in a contained time period starting the year before menopause and including the two years following menopause. It’s scary to think that a natural life transition can leave us with weaker bones. Why would Mother Nature allow this to happen? Well, she probably didn’t.

Bone loss in menopause happens primarily because of imbalanced hormones (not just naturally dropping estrogen levels) and a lack of exercise — both of which Mother Nature gave us the resources to overcome. In this article, we’ll focus on exercise.

The most important thing for you to remember is: the bone you’ve got is good so let’s keep it! The old adage, use it or lose it, certainly applies to bone health and menopause. Let’s take a closer look.

Maintaining bone in menopause

It’s common for women to lose about 10% of their bone in the 10 years around menopause, but now we know it’s that year before menopause and the two years after that count most. It’s hard to know for sure when you’re exactly one year away from menopause, but you’ll begin to get clues from your body when your hormones start shifting. These may include hot flashes and night sweats, weight gain, fuzzy thinking, fatigue, hair loss and more. Symptoms associated with menopause sometimes begin several years before our periods actually stop. So even if you start a new exercise routine well before menopause, it’s not as if there are any harmful side-effects!

Here are some of the exercise modalities that I believe are great for bone health. I explore each of these with a personal trainer in my Exercising for bone health DVD.


Pilates. I like Pilates as an exercise because it has such a focus on alignment. We tend to look down and bend down as we age, leading to poor posture and weakness in the small muscles around the spine. Pilates helps strengthen these spinal muscles and the bone attached to them. Pilates also helps us experience a feeling of elongation as well as encouraging deep, natural breathing.


Yoga. Yoga is wonderful for bone health on many levels. For one, it helps improve balance and coordination, both important in preventing falls. In yoga you learn to hold poses for long periods and shift your body weight to one side or the other. Both of these practices offer an extra load that creates more tension from tendons pulling on bone. The more tension, the more new bone your body will make. Yoga also has lots of stretching, which we now understand also stimulates new bone growth. Dr. Loren Fishman has proven in his pilot studies that just 10 minutes of yoga a day can improve bone density.

Isometric exercise

Isometric exercise. In my practice, I’ve used resistance bands and the Osteoball to facilitate the pushing and pulling action that accompanies isometric exercise. The reason this type of exercise is so good for bone is that it can isolate one muscle group at a time to really work that muscle group and the bone attached to it. Isometric exercise is particularly helpful if you have joint tenderness or pain.

Weight- bearing training

Weight- bearing training & Strength training: Because our bones build and rebuild as needed, intense weight-bearing leads to muscle and bone growth. The more intense or heavier loading leads to even more bone growth. One German study indicates an 11% increase in the bone mineral density of the hip after three years of strength training in postmenopausal women. In this study the strength training regimen was enhanced by use of a weighted vest while exercising.

tai chi

Tai Chi: Tai Chi is an ancient exercise that helps strengthen bone while relaxing the mind. It increases balance and flexibility and has been shown in multiple studies to slow bone loss. Research shows that long-term practitioners have better bone mass density as they age than those who don’t practice Tai Chi.

Get started now:

Gentle, low-impact exercise slide show

Exploring any and all of these bone-friendly exercises will help you preserve the healthy bone you have right now. There are also many other ways to use your bones and muscles more, such as:

  • Walking after dinner or before work in the morning
  • Running up the stairs at least once a day
  • Hopping on one leg, or both
  • Riding your bike to work
  • Going dancing or clearing out your living room for a dance party

Here’s your chance to get creative and have some fun while moving your body and building your bones. Exercise will likely help with your other menopause symptoms as well.

Notes on building bone during menopause

If you want to build bone during the menopause transition, it may take a more intensive exercise plan. In the case of early post menopausal women with osteopenia, some research indicates that the isolated effect of simply increasing habitual physical activity does little to increase muscle strength. But this just means that women with a diagnosis of osteopenia or at otherwise higher risk need a more deliberate and structured exercise program instead of randomly increasing habitual physical activity. Use of a weighted vest while exercising is often of great benefit during this period of rapid bone loss. It might also be a time to consult a personal trainer for help crafting a routine to fit your needs and preferences.

To learn more about menopause and your bones, see my article on how to stop bone loss during the menopausal transition.

Exercise does not stand alone

Exercise is one of those “bone treatment” plans that doesn’t have negative side effects. As far as I can tell, the side effects of exercise are all positive. But exercise isn’t the only way to create better bone health through menopause.

There are 20 key nutrients that aid us in building bone and I recommend trying our exclusive Better Bones supplements to be sure you get enough of all of these nutrients every day. As I mentioned earlier, hormonal balance is also important in preventing menopausal bone loss. Eating an alkaline diet, engaging in practices that promote regular detoxification, and managing your stress also boost your bone health. Our Better Bones Program can help you with all of these elements — and we make it simple and easy to understand.


1 Nelson, M. 2000. Strong Women, Strong Bones: Everything You Need to Know to Prevent, Treat, and Beat Osteoporosis, 221. NY: Berkley Publishing Group.

2 Zhang, P., et al. 2008. Joint loading modality: Its application to bone formation and fracture healing. Br. J. Sports Med., 42 (7), 556–560. URL (abstract): http://bjsm.bmj.com/content/42/7/556.abstract (accessed 01.13.2010).

3 Brown, S. 2000. Better Bones, Better Body, 305. Los Angeles: Keats Publishing.

4 Guadalupe–Grau, A., et al. 2009. Exercise and bone mass in adults. Sports Med., 39 (6), 439–468. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/19453205 (accessed 01.13.2010).

5 Barry, D., & Kohrt, W. 2009. Exercise and the preservation of bone health. J. Cardiopulm. Rehab. Prev., 28 (3), 153–162. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/18496313 (accessed 01.13.2010).

6 Huang, T., et al. 2003. Effects of different exercise modes on mineralization, structure, and biomechanical properties of growing bone. J. Appl. Physiol., 95 (1), 300–307. URL: http://jap.physiology.org/cgi/content/full/95/1/300 (accessed 01.13.2010).

7 Manske, S., et al. 2009. Bone health: Part 2, physical activity. Sports Health, 1 (4), 341–346. URL: http://sph.sagepub.com/content/1/4/341.abstract (accessed 01.11.2010).

8 Taaffe, D., et al. 1995. Differential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletes. J. Bone Miner. Res., 10 (4), 586-593. URL: http://jap.physiology.org/cgi/external_ref?access_num=A1995QQ47900010&link_type=ISI (accessed 01.13.2010).

9 Guadalupe–Grau, A., et al. 2009.

10 Taaffe, D., et al. 1995.

11 Myers, E., et al. 1993. Geometric variables from DXA of the radius predict forearm fracture load in vitro. Calcif. Tissue Int., 52 (30), 199–204. (accessed 01.13.2010).

12 Fishman, L. 2009. Yoga for osteoporosis: A pilot study. Topics in Ger. Rehab., 25 (3), 244–250. URL (abstract): http://journals.lww.com/topicsingeriatricrehabilitation/Abstract/2009/07000/Yoga_for_Osteoporosis__A_Pilot_Study.9.aspx (accessed 01.11.2010).

13 Phoosuwan, M., et al. 2009. The effects of weight-bearing yoga training on the bone resorption markers of postmenopausal women. J. Med. Assoc. Thai., 92 (Supple. 5), S102–S108. URL (abstract) http://www.ncbi.nlm.nih.gov/pubmed/19891384 (accessed 01.14.2010).

14 Engelke, K., et al. 2006. Exercise maintains bone density at spine and hip EFOPS: A 3-year longitudinal study in early postmenopausal women. Osteoporos. Int., 17 (1), 133–142. URL: http://www.ncbi.nlm.nih.gov/pubmed/16096715 (accessed 07.22.2008).

15 Pruitt, L. et al. 1992. Weight-training effects on bone mineral density in early postmenopausal women. J. Bone Miner. Res, 7 (2), 179–185. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/1570762 (accessed 07.22.2008).

16 Kemmler, W., et al. 2004. The effect of habitual physical activity, non-athletic exercise, muscle strength, and VO2max on bone mineral density is rather low in early postmenopausal osteopenic women. URL (PDF): http://www.ismni.org/jmni/pdf/17/13KEMMLER.pdf (accessed 01.14.2010).

Further reading

Bonnet, N., & Ferrari, S. 2010. Exercise and the skeleton: How it works and what it really does. IBSM BoneKEy, 7 (7), 235–248. URL: http://www.bonekey-ibms.org/cgi/content/full/ibmske;7/7/235 (accessed 07.20.2010).

General Research on Exercise, Bone Strength and Fracture Reduction

Barry, D. W., and W. M. Kohrt. 2008. Exercise and the preservation of bone health. Journal of Cardiopulmonary Rehabilitation and Prevention 28:153–162.

Bloomfield, S., N. Williams, D. Lamb, and R. Jackson. 1993. Non-weightbearing exercise may increase lumbar spine bone mineral density in healthy postmenopausal women. American Journal of Physical Medicine and Rehabilitation 72:204–209.

Brown, S. 2000. Better bones, better body. Los Angeles: Keats.

Carter, M. D., G. Lester, R. DeMasi, and R. Talmage. 1991. Bone mineral content at three sites in normal perimenopausal women. Clinical Orthopaedics and Related Research 266:295–300.

Donaldson, C., S. Hulley, J. Vogel, R. Hattner, J. Bayers, and D. McMillan. 1970. Effect of prolonged bed rest on bone mineral. Metabolism 19:1071–1084.

Feskanich, D., W. Willett, and G. Colditz. 2002. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. Journal of the American Medical Association 288:2300–2306.

Frost, H. M. 2001. From Wolff’s law to the Utah paradigm: Insights about bone physiology and its clinical applications. Anatomical Record 262:398–419.

Guadalupe-Grau, A., T. Fuentes, B. Guerra, and J. A. L. Calbet. 2009. Exercise and bone mass in adults. Sports Medicine 39:439–468.

Krolner, B., and B. Toft. 1983. Vertebral bone loss: An unheeded side effect of therapeutic bed rest. Clinical Science 64:537–540.

Lanyon, L. E. 1993. Skeletal responses to physical loading. In Physiology and pharmacology of bone, ed. G. R. Mundy and T. J. Martin. Berlin: Springer-Verlag.

Manske, S. L., C. R. Lorincz, and R. F. Zernicke. 2009. Bone health: Part 2, physical activity. Sports Health 1:341–346.

Martin, A. D., and R. G. McCulloch. 1987. Bone dynamics: Stress, strain and fracture. Journal of Sports Sciences 5:155–163.

Paganini-Hill, A., A. Chao, R. K. Ross, and B. E. Henderson. 1991. Exercise and other factors in the prevention of hip fracture: The Leisure World Study. Epidemiology 2:16–25.

Sinake, M. 1988. Exercise and physical therapy. In Osteoporosis: Etiology, diagnosis, and management, ed. B. L. Riggs and L. J. Melton III. New York: Raven Press.

Whedon, G. D. 1984. Disuse osteoporosis: physiological aspects. Calcified Tissue International 36(Supplement 1):S146–S150.

Zhang, P., G. M. Malacinski, and H. Yokota. 2008. Joint loading modality: Its application to bone formation and fracture healing. British Journal of Sports Medicine 42:556–560.

Strength Training and Weight Bearing

Cussler, E. C., T. G. Lohman, S. B. Going, L. B. Houtkooper, L. L. Metcalfe, H. G. Flint-Wagner, R. B. Harris, and P. J. Teixeira. 2003. Weight lifted in strength training predicts bone change in postmenopausal women. Medicine and Science in Sports and Exercise 35:10–17.

Dalsky, G., K. Stocke, A. Ehsani, E. Slatopolsky, W. Lee, and S. Birge, Jr. 1988. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Annals of Internal Medicine 108:824–828.

Engelke, K., W. Kemmler, D. Lauber, C. Beeskow, R. Pintag, and W. A. Kalender. 2006. Exercise maintains bone density at spine and hip EFOPS: A 3-year longitudinal study in early postmenopausal women. Osteoporosis International 17:133–142.

Fiatarone, M. A., E. C. Marks, N. D. Ryan, C. N. Meredith, L. A. Lipsitz, and W. J. Evans. 1990. High-intensity strength training in nonagenariams: Effects on skeletal muscle. Journal of the American Medical Association 263:3029–3034.

Grove, K. A., and B. R. Londeree. 1992. Bone density in postmenopausal women: High impact vs low impact exercise. Medicine and Science in Sports and Exercise 24:1190–1194.

Jessup, J. V., C. Horne, R. K. Vishen, and D. Wheeler. 2003. Effects of exercise on bone density, balance, and self-efficacy in older women. Biological Research for Nursing 4:171–180.

Kemmler, W., K. Engelke, J. Weineck, J. Hensen, and W. A. Kalender. 2003. The Erlangen fitness osteoporosis prevention study: A controlled exercise trial in early postmenopausal women with low bone density—first-year results. Archives of Physical Medicine and Rehabilitation 84:673–682.

Kemmler, W., S. von Stengel, J. Weineck, D. Lauber, W. Kalender, and K. Engelke. 2005. Exercise effects on menopausal risk factors of early postmenopausal women: 3-yr Erlangen fitness osteoporosis prevention study results. Medicine and Science in Sports and Exercise 37:194–203.

Pruitt, L. A., R. D. Jackson, R. L. Bartels, and H. J. Lehnhard. 1992. Weight-training effects on bone mineral density in early postmenopausal women. Journal of Bone and Mineral Research 7:179–185.

Smith, E. L., Jr., W. Reddan, and P. E. Smith. 1981. Physical activity and calcium modalities for bone mineral increase in aged women. Medicine and Science in Sports and Exercise 13:60–64.

Taaffe, D. R., C. Snow-Harter, D. A. Connolly, T. L. Robinson, M. D. Brown, and R. Marcus. 1995. Differential effects of swimming versus weight-bearing activity on bone mineral status of eumenorrheic athletes. Journal of Bone and Mineral Research 10:586–593.

Tsukahara, N., A. Toda, J. Goto, and I. Ezawa. 1994. Cross-sectional and longitudinal studies on the effect of water exercise in controlling bone loss in Japanese postmenopausal women. Journal of Nutritional Science and Vitaminology (Tokyo) 40:37–47.

Vincent, K. R., and R. W. Braith. 2002. Resistance exercise and bone turnover in elderly men and women. Medicine and Science in Sports and Exercise 34:17–23.

Weighted Vest Strength Training

Greendale, G. A., G. J. Salem, J. T. Young, M. Damesyn, M. Marion, M. Y. Wang, and D. B. Reuben. 2000. A randomized trial of weighted vest use in ambulatory older adults: Strength, performance, and quality of life outcomes. Journal of the American Geriatrics Society 48:301–311.

Puthoff, M. L., B. J. Darter, D. H. Nielsen, and H. J. Yack. 2006. The effect of weighted vest walking on metabolic responses and ground reaction forces. Medicine and Science in Sports and Exercise 38:746–752.

Shaw, J. M., and C. M. Snow. 1998. Weighted vest exercise improves indices of fall risk in older women. Journal of Gerontology: Medical Sciences 53A:M53–M58.

Snow, C. M., J. M. Shaw, K. M. Winters, and K. A. Witzke. 2000. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. Journal of Gerontology: Medical Sciences 55A:M489–M491.

Snow-Harter, C., and R. Marcus. 1991. Exercise, bone mineral density, and osteoporosis. Exercise and Sport Sciences Reviews 19:351–388.


Balk, J., M. Gluck, L. Bernardo, and J. Catov. 2009. The effect of yoga on markers of bone turnover in osteopenic women: A pilot study. International Journal of Yoga Therapy 19:63–68.

Fishman, L. M. 2009. Yoga for osteoporosis: A pilot study. Topics in Geriatric Rehabilitation 25:244–250.

Fishman, L., and E. Saltonstall. 2010. Yoga for osteoporosis: The complete guide. New York, Norton.

Greendale, G. A., A. McDivit, A. Carpenter, L. Seeger, and M. H. Huang. 2002. Yoga for women with hyperkyphosis: Results of a pilot study. American Journal of Public Health 92:1611–1614.

Greendale, G. A., M. H. Huang, A. S. Karlamangla, L. Seeger, and S. Crawford. 2009. Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: Results of a randomized controlled trial. Journal of the American Geriatric Society 57:1569–1579.

Kamei, T., Y. Toriumi, H. Kimura, S. Ohno, H. Kumano, and K. Kimura. 2000. Decrease in serum cortisol during yoga exercise is correlated with alpha wave activation. Perceptual and Motor Skills 90:1027–1032.

Phoosuwan, M., T. Kritpet, and P. Yuktanandana. 2009. The effects of weight bearing yoga training on the bone resorption markers of postmenopausal women. Journal of the Medical Association of Thailand 92(Supplement 5):S102–S108.

West, J., C. Otte, K. Geher, J. Johnson, and D. C. Mohr. 2004. Effects of Hatha yoga and African dance on perceived stress, affect and salivary cortisol. Annals of Behavioral Medicine 28:114–118.

Tai Chi

Chan K., L. Qin, M. Lau, J. Woo, S. Au, W. Choy, K. Lee, and S. Lee. 2004. A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Archives of Physical Medicine and Rehabilitation 85:717–722.

Harmer, P. A., and F. Li. 2008. Tai Chi and falls prevention in older people. Medicine and Sports Science 52:124–134.

Jin, P. 1989. Changes in heart rate, noradrenaline, cortisol and mood during Tai Chi. Journal of Psychosomatic Research 33:197–206.

Lee, M. S., M. H. Pittler, B. C. Shin, and E. Ernst. 2008. Tai Chi for osteoporosis: A systematic review. Osteoporosis International 19:139–146.

Li, F., P. Harmer, K. J. Fisher, E. McAuley, N. Chaumeton, E. Eckstrom, and N. L. Wilson. 2005. Tai Chi and fall reductions in older adults: A randomized controlled trial. The Journals of Gerontology A 60:187–194.

Murphy, L., and B. B. Singh. 2008. Effects of 5-form, Yang style Tai Chi on older females who have or are at risk for developing osteoporosis. Physiotherapy Theory and Practice 24:311–320.

Qin, L., S. Au, W. Choy, P. Leung, M. Neff, K. Lee, M. Lau, J. Woo, and K. Chan. 2002. Regular Tai Chi Chuan exercise may retard bone loss in postmenopausal women: A case-control study. Archives of Physical Medicine and Rehabilitation 83:1355–1359.

Qin, L., W. Choy, K. Leung, P. C. Leung, S. Au, W. Hung, M. Dambacher, and K. Chan. 2005. Beneficial effects of regular Tai Chi exercise on musculoskeletal system. Journal of Bone and Mineral Metabolism 23:186–190.

Sandlund, E. S., and T. Norlander. 2000. The effects of Tai Chi Chuan relaxation and exercise on stress responses and well-being: An overview of research. International Journal of Stress Management 7:139–149.

Shen, C. L., J. S. Williams, M. C. Chyu, R. L. Paige, A. L. Stephens, K. B. Chauncey, F. R. Prabhu, L. T. Ferris, and J. K. Yeh. 2007. Comparison of the effects of Tai Chi and resistance training on bone metabolism in the elderly: A feasibility study. The American Journal of Chinese Medicine 35:369–381.

Song, R., B. L. Roberts, E. O. Lee, P. Lam, and S. C. Bae. 2010. A randomized study of the effects of T’ai Chi on muscle strength, bone mineral density, and fear of falling in women with osteoarthritis. Journal of Alternative and Complementary Medicine 16:227–233.

Tsang, W. W. N., and C. W. Y. Hui-Chan. 2003. Effects of Tai Chi on joint proprioception and stability limits in elderly subjects. Medicine and Science in Sports and Exercise 35:1962–1971.

Tsang, W. W. N., and C. W. Y. Hui-Chan. 2004. Effect of 4- and 8-wk intensive Tai Chi training on balance control in the elderly. Medicine and Science in Sports and Exercise 36:648–657.

Wayne, P. M., D. P. Kiel, D. E. Krebs, R. B. Davis, J. Savetsky-German, M. Connelly, and J. E. Buring. 2007. The effects of Tai Chi on bone mineral density in postmenopausal women: A systematic review. Archives of Physical Medicine and Rehabilitation 88:673–680.

Wolf, S. L., H. X. Barnhart, N. G. Kutner, E. McNeely, C. Coogler, and T. Xu. 1996. Reducing frailty and falls in older persons: An investigation of Tai Chi and computerized balance training. Journal of the American Geriatric Society 44:489–497.

Woo, J., A. Hong, E. Lau, and H. Lynn. 2007. A randomized controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age and Ageing 36:262–268.


Betz, S. R. 2005. Modifying Pilates for clients with osteoporosis. IDEA Fitness Journal, April. Available: http://www.ideafit.com/fitness-library/pilates-osteoporosis.

Kuo, Y. L., E. A. Tully, and M. P. Galea. 2009. Sagittal spinal posture after Pilates-based exercise in healthy older adults. Spine 34:1046–1051.