What's really happening
As estrogen drops, your body starts breaking down old bone faster than it can rebuild new bone. That gradual imbalance leads to weaker, more fragile bones—making you more prone to fractures from everyday mishaps.
But why?
Estrogen plays a key role in bone renewal. When it drops, bones break down faster than they rebuild.
Scientific Breakdown
Your bones are living tissue—constantly breaking down and rebuilding. Estrogen keeps that cycle in balance. During perimenopause and menopause, falling estrogen levels shift the balance toward more breakdown and less rebuilding. The result: porous, fragile bones vulnerable to fractures even from minor falls or pressure.
↓ Estrogen → ↑ Bone resorption (breakdown)
↓ Calcium absorption from food
↑ Inflammation = weaker bone formation
Essentially…
Bone loss during menopause is invisible, but serious. It’s one of the few symptoms that can impact you long after hot flashes fade. The good news? You can intervene early.
🔗 [Deep Dive: Estrogen, Bone Density, and Midlife Risk → coming soon]
See a doctor if …
You’ve had a fracture after a minor fall
You’re under 60 and losing height or experiencing back pain
Your doctor hasn’t brought up a bone density scan
Vertebral fractures
Vitamin D deficiency
Undiagnosed autoimmune conditions
Frequently Asked Questions (FAQs) about
Bone Fractures / Osteoporosis
Q: Can I rebuild bone once it’s lost?
Yes—some therapies can increase bone density over time.
Q: Is this just something that happens with age?
No. It’s largely preventable with early awareness and action.
Q: Is HT more effective than calcium or exercise?
They work best together—but HT is often more powerful than supplements alone.
“My scan showed early bone loss, and I freaked out. But my doctor started me on HT and I began strength training. At my next DEXA, my bone density had actually improved. I didn’t even think that was possible.”
— FLUXX community member, age 54
FLUXX Recommendations
Ask your provider for a bone density scan (DEXA)
Start strength-based movement + weight-bearing exercises
Consider HT or supplements if you’re early in the transition
Non-Hormonal Medications
Bisphosphonates (alendronate, etc.)
SERMs like raloxifene
Monoclonal antibodies (denosumab, etc.)
Anabolic options (e.g. teriparatide) in advanced cases
Calcium (food sources + supplementation)
Vitamin D (sunlight, food, supplements)
Magnesium + vitamin K2
Bone broth, leafy greens, sardines
Lifestyle Suggestions
Resistance training: bodyweight, bands, or weights
Balance exercises (Tai Chi, yoga, walking on uneven terrain)
Fall prevention: home safety, good lighting, supportive shoes
Minimize smoking, soda, and heavy alcohol use
Myth-Busting
Estrogen isn’t just for hot flashes—it’s a key bone protector.
Modern Guidance
HT is FDA-approved to prevent bone loss in menopause. Calcium, vitamin D, and weight-bearing exercise (like walking or resistance training) help maintain strength. If needed, medications like bisphosphonates or even newer agents like romosozumab may be used. A DEXA scan can measure your current bone health.
Ask yourself
“Has my doctor ever done a DEXA scan?”
"Do I have a family history of osteoporosis or fractures?”
“Am I early enough in menopause to benefit from HT?”
Ask your doctor
“Should I get a bone density scan?”
“Is estrogen therapy right for me?”
“What else can I do to protect my bones right now?”
🔗 [See FLUXX’s full breakdown of the 2002 study →]
🔗 [Osteoporosis Guidelines from The Menopause Society → coming soon]
• Untreated bone loss can lead to fractures, long-term disability, or even early mortality after hip fracture
• HT reduces fracture risk—but must be tailored to your health profile
