Why strong bones matter more than you think
A midlife health wake-up call
What if your bones are silently weakening and you don’t even know it?
For 1 in 2 women in the UK, osteoporosis isn’t a future concern. It’s a very real, very current risk. And it doesn’t just mean a broken bone. It means losing mobility. Losing confidence. Losing independence. But this isn’t a fear story. It’s your invitation to take back control of your health, one habit, one choice at a time.
In this week’s Women’s Health Unwrapped podcast, I sat down with GP and menopause expert Dr Nancy Allen to talk about the health risks too many of us are overlooking. And how we can begin protecting our future selves today.
The health risk most women don’t know they’re carrying
Nancy shared a statistic that made us both stop in our tracks: breaking a bone is now the fourth leading cause of death. Women are more likely to have osteoporosis than men, and half of women over the age of 50 will experience a fragility fracture in their lifetime (compared to 20.7% of men). And yet, when we think about our health risks in midlife, osteoporosis rarely makes the list.
We’re so used to hearing about breast cancer, high cholesterol, or weight gain that we don’t realise just how serious bone fragility can be. And the scary part? You often won’t feel it coming. Many women only discover they have osteoporosis after their first fracture. There is most often, no symptoms or key warning signs.
But here’s what’s equally important: this risk is not inevitable. In fact, it’s largely preventable
Nancy’s story: early menopause and a wake-up call
Nancy was diagnosed with osteopenia (a precursor to osteoporosis) after entering menopause at 43. She had all the classic midlife responsibilities—children, career, a packed diary—and, like so many of us, had put herself at the bottom of the list.
That diagnosis was her turning point.
She began walking every day, lifting weights, adjusting her nutrition, and learning how to work with her body instead of against it. She focused on sleep, recovery, and consistency—not perfection. And today, her bone health has improved without needing medication.
It’s a powerful reminder: you can’t outsource your health. But you can take small, meaningful steps to protect it.
The inside of our bones is constantly being broken down and rebuilt by specialist bone cells. This process, called bone remodelling, helps to keep bones healthy and strong.
During the menopause, the drop in oestrogen causes this process to become out of balance. More bone is broken down than formed, leading to bone loss. Bone loss happens more quickly for a few years around the menopause. You then continue to lose bone at a slower rate as you get older.
Over time, you may develop osteoporosis and a higher risk of breaking bones in later life. This is particularly likely if you have an early menopause, like Nancy experienced.
We aren’t taught to think about our bone health as women. Most of us only think about how we look—our shape and size—when we focus on improving our health.
Strength isn’t optional—it’s essential
We often associate strength with appearance—toned arms, flatter stomachs, a certain number on the scales. But what Nancy and I explored is that real strength is functional. It’s the ability to move freely, carry your shopping, get up off the floor, and reduce the risk of injury as you age.
Resistance training, walking, balance work—these are no longer “nice to haves.” They’re essential to maintaining your freedom, energy, and quality of life. And the key piece that so many women in midlife miss is that we must future-proof ourselves, we need to shift our mindset from focusing on what we ‘think and believe’ will bring us happiness and confidence now, to feeling strong and well throughout our entire lifespan.
And no, you don’t have to live in the gym. Nancy started with kettlebells at home. I have worked out at home since the start of the COVID Pandemic. You can start with a resistance band and 10 minutes a day. The goal is progress, not perfection.
Protein is your midlife superpower
Many women simply don’t eat enough protein (or most importantly, the right types of protein for strong health). It’s not about dieting, it’s about giving your body the building blocks it needs. Focus on quality over quantity and fuel your mind and body to feel strong and energised day-to-day, as well as building strength and health for the rest of your life.
Protein supports your hormones, muscles, bones, brain function and even your mood and energy. It’s a hot-topic online right now, one that is being discussed everywhere because there are so many different opinions and schools of thought on how much protein is optimal. I’m going to share below the current International guidelines along with guidance from a leading expert in nutrition:
The current international Recommended Dietary Allowance (RDA) for protein is 0.8 g per kg of body weight, regardless of age.
According to the World Health Organisation (WHO), you need to consume around 0.83 grams of protein per kilogram of body weight. So, someone who weighs 150 pounds needs around 54 g of protein a day. And someone weighing 200 pounds needs 72 g a day.
For those that are highly active or professional athletes, the RDA would need to be increased. So, unless you’re hitting the gym really hard, you’re unlikely to need extra protein.
Leading experts acknowledge that based on latest research and new insights, it may be necessary for this to be higher for women as they shift into their perimenopause and menopause season of life.
You may have heard women’s health and menopause experts sharing numbers for the real protein requirement between 1g to 1.8g per pound of ideal body weight. Given that a pound is just under half of one kilogram, these recommendations are incredibly high versus the international RDA.
One expert I align to is Dr Rupy Aujla who runs The Doctors Kitchen and recently published his book “Healthy High Protein”. His point of view on how much women in menopause should be consuming is between 1.2 to 1.5kg of protein per kg of weight per day.
Including enough of the right type of protein in your overall diet can make a huge difference in your strength, satiety, and stability. As Dr Rupy explains: “Look for proteins low in saturated fats and processed carbs, and rich in nutrients and beneficial compounds.”
If thinking about measuring and weighing protein feels overwhelming, just start by adding a protein-rich food to your breakfast or lunch. These changes compound over time. In my client work, I don’t enforce strict measurements as my approach is much more about creating a lifestyle that aligns to your goals, and most importantly, that is realistic and can become part of who you are. My advice is to make a decision on whether or not to have specific daily protein targets and tracking processes based on what works for you and your specific health and wellness goals.
What about HRT and supplements?
HRT (Hormone Replacement Therapy) can play a role in maintaining bone density, particularly when oestrogen levels drop post-menopause. It’s not a quick fix, but it’s a powerful tool for many women. HRT causes your oestrogen levels to increase. This can help to prevent bone loss and reduce your risk of developing osteoporosis and of breaking bones. In the UK, Oestradiol (oestrogen) HRT is licensed as a treatment to prevent osteoporosis.
Nancy’s advice? Talk to your GP. Understand your options. Use tools like QFracture.org to assess your personal risk. And remember: HRT is just one part of the picture. Lifestyle still matters—hugely. You must always take a 360 total body approach to building strong bones and overall health.
What else can you do to protect your bones?
Nancy shared some great tips to focus on for your habits toolkit to protect your bone strength and reduce your risk of both Osteoporosis and Sarcopenia (the loss of muscle mass).
Walk every day: build towards 10,000 steps to support heart and bone health. Take short walks throughout your day wherever possible to keep moving.
Diverse diet: vary the types of plant foods you include on your plate, focusing on nutrient dense nuts, seeds, beans, lentils and green cruciferous veg.
Lift something: strength training not only strengthens bones but also improves muscle strength and balance, reducing the risk of falls.
Limit alcohol: understand the impact alcohol has on your hormones and bone health. Excessive alcohol consumption is a key risk factor for Osteoporosis.
Listen to this podcast episode with Dr Nancy Allen to learn more about why bone health matters:
Like this topic? Find out more with these additional FREE resources:
Watch this brilliant and inspiring podcast episode with Mel Robbins and the world’s leading orthopaedic surgeon Dr Vonda Wright on how to protect your bones (this is a personal favourite episode of mine that inspired me in so many ways!)
Read this article from DR Louise Newson on HRT and Osteoporosis prevention.
Take a look at this insightful article by menopause advocate and journalist Kate Muir.
Complete your fracture risk assessment.
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