Pune:By the time many women cross 40, their lives are full – careers, children, ageing parents, social responsibilities. Unfortunately, this is also the age when their bones quietly start losing strength. Shoulder pain while lifting a bag, knee pain after a short walk, or a sudden fracture after a minor fall are often dismissed as “ageing” – but in many cases, they are early warning signs of **weak bones and changing hormones
What happens to women’s bones after 40?
A woman’s bone mass usually peaks by her late 20s. From the mid-30s onwards, there is a slow, natural decline. Around the time of perimenopause and menopause, falling oestrogen levels speed up this bone loss.
Oestrogen is not just a reproductive hormone; it is also a powerful protector of bone. As its levels drop: The body breaks down old bone faster than it builds new bone.
Bones become thinner, more porous and fragile – a condition called osteopenia which can progress to osteoporosis.
The risk of fractures in the spine, hip and wrist rises sharply, especially after minor falls.
In my practice, I often see women in their mid-40s to early 60s who have been ignoring joint pain for years, only to discover that their bone density is already in the “at risk” range.
Risk factors Indian women should be aware of Some risk factors are biological, but many come from lifestyle:Early menopause (before 45), surgical removal of ovaries or prolonged absence of periods
Low body weight, crash dieting or chronic undernutrition
Sedentary lifestyle, long sitting hours and minimal weight-bearing exercise
Low calcium and vitamin D intake, especially in women who avoid dairy or sun
Family history of osteoporosis or hip fracture
Long-term use of steroids or certain medications, smoking and excessive alcohol
Many Indian women also put their own nutrition last in the family, leading to years of quiet calcium and vitamin D deficiency.
How can women protect their bones after 40?
The good news is that bones are living tissue. Even after 40, much can be done to maintain strength and reduce fracture risk.
- Know your numbers
If you are above 40 and have any risk factors, speak to your doctor about: A vitamin D and calcium profile
A DEXA scan (bone density test), especially around or after menopause
These tests help classify you as normal, osteopenic or osteoporotic, and guide the treatment plan. - Build a bone-friendly plate
Aim for: Calcium-rich food: milk, curd, paneer, ragi, sesame seeds (til), green leafy vegetables.
Vitamin D safe morning sunlight, eggs with yolk, fortified foods; supplements if advised.
Adequate protein from dals, pulses, milk, eggs, fish or lean meats to support muscle strength.
Remember, tea and coffee in excess, aerated drinks and high-salt packaged foods can interfere with bone health if they dominate the diet. - Move with purpose – and warm up first
Bones and muscles respond wonderfully to regular, weight-bearing activity. At our clinic, we usually recommend: Brisk walking, stair climbing, light jogging (if knees permit)
Strength training with light weights or resistance bands
Simple balance exercises to prevent falls
Always do 5–10 minutes of warm-up and stretching before more intense activities like aerobics, Zumba or sports. This protects the joints – especially the shoulders and knees – and reduces the risk of ligament and muscle injuries. - Don’t ignore persistent pain
Ongoing backache, height loss, stooped posture, or repeated fractures after minor trauma are not “normal for age”. They demand evaluation by an orthopaedic specialist. Today, we have effective: Medications to slow bone loss or build bone
Physiotherapy and targeted exercises to strengthen muscles
Bracing and fall-prevention strategies for high-risk women
A final word to women in their 40s and beyond
Strong bones are not about looking young; they are about staying independent, mobile and pain-free in your 50s, 60s and 70s. You cannot change when menopause comes, but you can change how prepared your bones are for it.
If you are a woman over 40, take your bone health as seriously as your blood pressure or sugar. A little attention now – to food, sunlight, movement and timely check-ups – can mean the difference between a small stumble and a life-changing fracture.
By Dr. Sana Ahmed Sayyad, Consultant Orthopaedic Surgeon & Shoulder–Knee Specialist, Dr. Sayyad’s Orthopaedic Clinic, NIBM Road, Pune
