On October 18, 2026, Mid-day published a World Menopause Day guide to bone health around and after menopause. It featured clinicians Dr Sourabh Kulkarni and Dr Prashant Bhamare of Fortis Hiranandani Hospital and Dr Rakesh Pandit of Aakash Healthcare Superspeciality Hospital.
Does menopause change the usual approach to bone screening?
The screening framework summarized in the guide is risk-based: routine DEXA testing for women aged 65 and older, with earlier testing when individual risks warrant it. Menopause status alone is not presented as a reason for every younger woman to have a scan.
Rather than replacing that framework, the clinicians bring attention to the conversation that can happen before routine screening age. Their emphasis is on reviewing personal history during perimenopause instead of waiting for a fracture or assuming that everyone needs early testing.
This is a reported expert guide, not a new clinical trial or a formal guideline announcement. It brings together clinician interviews and screening advice rather than establishing a new standard of care. Its practical contribution is to connect hormonal change with individual risk assessment, appropriate exercise and a more careful approach to supplements.
Why can bone loss accelerate around menopause?
- Estrogen helps regulate the balance between bone breakdown and rebuilding. The clinicians quoted by Mid-day describe how declining estrogen during perimenopause and menopause can allow breakdown to outpace formation. Dr Pandit explains this through increased activity in osteoclasts, the cells involved in breaking down bone. This helps explain why the menopausal transition belongs in a bone-health conversation without making osteoporosis an inevitable outcome.
- The years around the final menstrual period deserve attention. The article reports that some women may lose up to approximately 20% of bone mineral density during the menopausal transition and early postmenopausal years. It explicitly says that outcomes vary. That figure is a possible upper-end experience described in the guide, not a prediction for every woman or a measure of what has happened to any individual reader.
- Hormonal change is part of the assessment rather than the whole assessment. The guide pairs its explanation of estrogen with medical history and lifestyle factors. The editorial lesson is to avoid opposing extremes: dismissing bone health because a woman feels well or treating menopause itself as a diagnosis. Understanding the biology should lead to a better risk discussion rather than an automatic product purchase.
Who may need a bone-density scan before 65?
- Fracture history and family history belong in the conversation. The guide identifies a previous low-trauma fracture and a parent’s hip fracture as reasons for a clinician to review risk. These details are more relevant to a screening decision than simply reaching perimenopause. A useful appointment discussion connects what has happened in a woman’s own life with the family history she knows.
- Some conditions and medicines may change the assessment. The article names early menopause and low body weight among the factors worth discussing. It also identifies long-term glucocorticoid use, rheumatoid arthritis and certain endocrine conditions. These are reasons for an individualized review, not a checklist that establishes osteoporosis or determines a scan decision without clinical judgment.
- Lifestyle is part of the picture without being the entire explanation. Smoking and excessive alcohol use appear in the guide’s risk summary, alongside physical inactivity. Dr Bhamare’s emphasis is on bringing these factors into a personal assessment rather than recommending universal early scanning. The relevant question is whether the combined history warrants earlier testing and how a result would affect care.
How do DEXA and fracture-risk assessment fit together?
- DEXA measures bone mineral density. The guide describes measurements at the hip and lumbar spine. Its role is different from judging bone health through symptoms or a blood test. For readers preparing for a scan discussion, Refemina’s explanation of how bone-density results inform next steps provides related context without replacing interpretation by a qualified clinician.
- FRAX addresses fracture probability. The article describes FRAX as estimating 10-year fracture probability. Bone density and fracture probability are related questions but are not interchangeable descriptions. In a clinical discussion, asking what a test or assessment measures can help keep the focus on its purpose rather than treating any single result as a complete account of bone health.
- Testing should connect to a decision. The guide’s practical framing is to ask whether a DEXA scan or fracture-risk assessment is appropriate and how the findings would shape the next steps. That is more useful than pursuing testing simply because menopause has begun. It also keeps an earlier conversation distinct from an automatic recommendation for an earlier scan.
Which symptoms deserve medical assessment?
- Feeling normal does not rule out early bone loss. Dr Pandit notes that a normal-feeling body is not evidence that bone density is unchanged. The article describes osteoporosis as often symptomless until structural failure. It also separates joint stiffness from a diagnosis: stiffness can have several causes and should not automatically be attributed to menopause or osteoporosis.
- Changes in height or posture warrant a clinical conversation. Dr Kulkarni recommends discussing persistent bone pain, height loss or postural changes with a doctor. The guide identifies progressive height loss and a newly stooped posture as warning signs. These observations belong in a medical assessment rather than being dismissed as an expected part of getting older or interpreted through online symptom lists.
- A fracture after minor trauma or persistent or sudden back pain also needs assessment. These are warning signs identified in the article. They are not invitations to diagnose the cause at home. The practical distinction is between routine discussion of future risk and assessment of a change that has already occurred; the latter should not be replaced by exercise advice or supplement shopping.
What does the guide say about strength training?
- The exercise approach combines different kinds of activity. The clinicians recommend weight-bearing movement together with resistance work and balance practice. The article gives brisk walking, stair climbing and dancing as examples of weight-bearing activity. Its message is broader than finding a single preferred workout: bone and muscle health sit within a combination of activities rather than one exercise being presented as a complete answer.
- An exercise plan should reflect health history and be built gradually. The guide places particular weight on professional supervision for people with established osteoporosis or a previous spinal fracture. It cautions against unsupervised high-impact jumping, heavy weightlifting and repeated deep forward bends in those circumstances. This is a targeted safety warning, not a blanket statement that women after menopause should avoid resistance training.
- Exercise supports care rather than replacing it. The experts distinguish movement for bone and muscle health from an osteoporosis treatment plan. A training routine does not remove the need for an appropriate assessment when risk factors or warning signs are present. Refemina’s overview of how resistance, impact and balance fit together offers wider educational context for that discussion.
Why should supplements follow a clinical review?
- Calcium and vitamin D are not automatic purchases. The Mid-day guide advises against independently starting high-dose supplements. It describes diet and test results as relevant to the decision, together with medical history. The practical starting point is therefore a review of what a woman already gets from food and what her clinical circumstances indicate, not the assumption that menopause creates the same supplement requirement for everyone.
- The review may involve more than a nutrient result. The article names calcium and vitamin D assessment alongside kidney-function review. Thyroid status may also be relevant. These details explain why a supplement decision belongs within a healthcare conversation rather than being based on a marketing claim. They also distinguish a clinical review from simply choosing between products on a shelf.
- A normal blood calcium result does not rule out osteoporosis. The article makes that distinction explicitly and says supplements alone may be insufficient when osteoporosis is present. Neither taking a supplement nor receiving a normal blood result should be treated as a substitute for appropriate evaluation or care. Refemina’s broader discussion of food and strength through the menopause years places nutrition within a wider health picture rather than a restrictive diet or single-product answer.
What should this mean for future menopause care?
The practical direction is earlier risk conversations, with screening and care shaped by personal history rather than automatic supplements or universal early scans.
How Refemina helps
Bone-risk assessment belongs with a woman and her clinician; Refemina’s role is to make the surrounding health information clearer. Its research-led coverage addresses messages that turn menopause into a supplement or weight-loss opportunity, helping readers understand physical change alongside strength and confidence rather than through a single-product answer.
Explore Resources
Sources
- World Menopause Day 2026: An expert health guide for women to deal with postmenopausal bone loss
