When I recently received a diagnosis of osteopenia, I felt a deep wave of grief and concern for my bones and my future health and wellbeing.  As a person who enjoys a very active life of yoga, gardening, bush walking etc, the thought of developing osteoporosis and breaking bones to render me immobile was terrifying. 

The diagnosis came at age 56. After navigating the many challenges of perimenopause, I had finally reached post-menopause and was beginning to experience hormonal stability. Yet, this new phase presented another wave of challenges, reminding me that menopause continues to impact the body.

Rather than feeling defeated, I chose to see this diagnosis as a call to action to explore how I can prevent osteoporosis.. 

As a yoga practitioner and teacher, as well as an advocate for holistic health, I realised that I had powerful resources and also practitioners in my life that could help me manage osteopenia. I found myself underwhelmed with the options that the mainstream health providers offered, which was HRT/MHT or calcium tablets, which in my view are way too simplistic and so I embarked on a journey to discover how I can holistically support my bones.  

In this blog, I share my personal journey and the strategies I discovered to strengthen my bones and reclaim my health and to subequently prevent osteoporosis.  I hope that my reflections help inspire you in some way. Do let me know if you have any questions, thoughts and reflections upon reading this as I would love to hear from you. 

Important Disclaimer: This blog is for educational purposes only. I recommend that if you have been diagnosed with osteopenia or osteoporosis, or want to know the state of your bone health,  that you seek advice from a suitable qualified health practitioner to identify what is your unique situation and what lifestyle changes you can make to build strong healthy bones into the future. 

Preventing Osteopenia and Osteoporosis in Menopause 

It is often only in midlife when women become aware or prioritise the importance of bone health.  Sadly, at this stage the foundation for our bone health has largely already been laid down. In many ways we have missed the primary prevention boat! 

Our early years were crucial in building bone health—our genetic inheritance, childhood and adolescent diets, exercise habits, and even factors like any medications we had when younger all played a role. 

Bone health peaks around the age of 30, and from then on a natural decline begins, particularly accelerating during menopause. As women enter menopause, the drop in oestrogen levels can lead to reduced bone density, increasing the risk of osteopenia and osteoporosis.

The good news is that whilst we can’t change the past, there are lifestyle changes we can make now to protect and strengthen our bones in midlife. In this blog I explore three priority areas of holistic health care for bones: 

1. Regular Yoga practice as an overall holistic approach to bone health. 
2. Ensuring we get adequate nutrition for bone remodelling; 
3. Suitable weight bearing exercise to build bone density safely.  

1. Yoga to prevent osteoporosis 

Yoga offers a holistic approach to bone health and is a central part of my approach to my overall health and wellbeing.   

Strength and flexibility, relaxation and stress reduction are important aspects of supporting good bone health and yoga offers us many practices to support those.

A suitably modified asana practice can offer a gentle yet effective way to maintain bone strength. Many poses help stimulate bone growth, improve balance (to prevent falls), and enhance posture.

Margot Porter, senior yoga teacher trainer and creator of Yoga for Menopause Wellbeing, suggests a Hatha or Flow practice that warms the body to help build strength without overexerting or agitating vata, which can increase the dryness and the weakening of bones.   Choose a sequence with generous warm up to lubricate the joints before moving onto poses that strengthen our muscles. Include push-pull actions, such as plank to down facing dog, repetitive sequencing, and holding poses for longer to build muscles and improve bone cell turnover. 

It’s important to note there are some things to avoid in your practice depending on where the osteopenia or osteoporosis is presenting,: 

• High impact exercise and sudden jerky movements
• Postures that reinforce a rounded back (kyphosis), instead focus on neutral spine
• Poses that bear weight directly on the neck or the head
• Extreme twists or twists with binds. 

With slight modifications to our practice we can continue a yoga practice that support in the prevention of  osteoporosis. Some examples of specific asana poses for bone health include: 

• Weight-Bearing Poses: Postures like Warrior I and II and Chair Pose require you to support your body weight, strengthening bones.
• Backbends and Chest Openers: Gentle backbends, like Bridge Pose or Cobra, help to open the chest and strengthen the spine, promoting healthy posture.
• Balance Poses: Tree Pose, Half-Moon Pose help improve balance, reducing the risk of falls and fractures.
• Strengthening Poses: Postures like Plank, Downward-Facing Dog, and Boat Pose help to engage and strengthen the muscles around the bones, providing additional support.

In any of the above poses you can use props such as the wall or a chair to provide support for balance to prevent risk of falls. Yoga for Osteoporosis by Loren Fishman and Ellen Saltonstall who provide a useful resource demonstrating adaptations of yoga poses for osteopenia and osteoporosis. 

Stress can exacerbate bone loss by increasing cortisol levels, which negatively affect bone density, so include restorative yoga practices and  Pranayama (breath work) can help calm the nervous system and reduce stress, thereby supporting overall bone health. Yin yoga is also beneficial in calming the nervous system and reduce tension whilst  supporting flexible nourished joints and hips.  

Consistency is key in using yoga to prevent bone loss. A regular practice, at least 3-4 times a week will help to support our bone strength over time. 

Also as a spiritual practice, yoga also offers us the overall support through our menopause transition in understanding we are an eternal soul. This helps us come to terms with the stark truth that our body is impermanent and eventually dissolves back into the earth. 

Through mindful movement, meditation, and breath work, yoga can help cultivate acceptance of this truth. It fosters compassion for our changing bodies and invites us to find peace in the natural cycles of life. In this way, yoga becomes more than just a practice for physical health—it becomes a path to spiritual understanding and serenity.

Whilst we are spiritual beings, it is also essential to honour and prioritise adequate support for the physical body that we inhabit. 

I soon realised after my diagnosis and my subsequent research, that yoga alone was not enough to reverse osteopenia. So I turned to the current evidence based approaches for bone density: nutrition and weight lifting to complement my yoga practice.

2. Nutrition to prevent osteoporosis 

A  key element in maintaining strong bones is proper nutrition. Our bodies rely on essential minerals for bone health. Importantly, we now know that if our bodies are not functioning optimally (especially our gut health) we won’t absorb the nutrients critical for bone strength. Nourishing our bodies with the right foods and ensuring we can fully absorb the nutrients is crucial for maintaining bone health as we age.

What became apparent to me very early on was my GP’s advice to simply increase calcium was too simplistic. Preventing osteoporosis requires a delicate balance of various minerals and vitamins.

Before making any changes to my diet, I got a thorough blood test done to identify what were my unique bio markers.  I believe is important to see a Naturopath or Nutritionist who has expertise in women’s health, and not just manage this with off the shelf supplements. 

After getting the results, my Naturopath made personalised suggestions for my diet and lifestyle and only then recommended supplements as an added boost.   

The key nutrients that we need to be mindful of to include in our diet to enable healthy bones:

• Calcium-Rich Foods: Calcium is essential for bone strength. 
• Vitamin D: This vitamin helps the body absorb calcium.
• Magnesium and Potassium: These minerals support bone density including the assisting in the absorption of calcium. 
• Vitamin K plays a crucial role by helping regulate calcium.
• Bone-Building Protein: Protein is important to build muscle that in turn helps build bone health so having adequate protein in every meal is crucial. 

Overall my diet now is largely a high protein, plant-based, omnivorous wholefood diet. I also have a focus on staying well hydrated, drinking 2-3 litres of  good quality water and herbal teas each day, whilst at the same time minimising coffee and alcohol.  I undertake a seasonal cleanse in the Spring and a review of my bloods each year to see how I am tracking with my bio markers.

Whilst diet is a key component of healthy bones, diet alone will not remodel bones. It takes the delicate balance between adequate nutrition with appropriate exercise to increase bone density and delay the progression of osteopenia or osteoporosis.

3. Weight Bearing Exercise to prevent osteoporosis

Weight-bearing exercises have been shown to be one of the most effective ways to improve bone density and prevent osteopenia and osteoporosis.

As we go through menopause, one of the most important issues to address and prevent is the progressive decline in our muscle function, balance and strength. 

Muscle and bone density are closely related because muscles exert force on bones during movement, which stimulates bone remodelling and growth. This relationship is especially important during menopause, when declining oestrogen levels accelerate bone loss. 

Stronger muscles support bones, reducing the risk of fractures and osteoporosis. In menopause, maintaining muscle mass through weight-bearing exercises helps slow the natural decline in bone density, promotes joint stability, and supports overall mobility and balance, all of which are crucial for preventing falls and maintaining quality of life as we age.

Weight bearing exercises force your body to work against gravity, which stimulates bone formation. According to Wolff’s Law, bones adapt based on the stress placed on them. When you engage in weight-bearing activities, the bones experience controlled stress, prompting them to rebuild and strengthen. Over time, this process increases bone mass and density. Regular weight-bearing exercise not only maintains bone health but also reduces the risk of fractures, which is especially important as we age. 

Whilst yoga asana can offer some weight bearing, after receiving a diagnosis of Osteopenia I needed more focused effort in building bone density. 

So I turned to weight lifting! 

Weightlifting provides a greater and more targeted mechanical load on the bones. Research shows that bones respond to higher-impact, weight-bearing activities by increasing their density more rapidly. Lifting heavier weights causes more significant stress on the bone tissue, prompting a stronger adaptive response.

Weightlifting is designed to focus on muscle hypertrophy (growth), which directly supports the bones by enhancing muscle mass and strength. Increased muscle mass provides better structural support to bones, reducing the risk of fractures. 

The principle of progressive overload—gradually increasing the weight lifted over time provides a constant, focused challenge ensuring that bones and muscles continually grow stronger. 

Weightlifting allows for more targeted engagement of major muscle groups like the legs, hips, and spine, which are critical areas for bone health. Exercises such as squats, deadlifts, and bench presses directly challenge these areas, promoting bone density where it is most needed to prevent osteopenia and osteoporosis-related fractures.

I go to a small specialised gym with an exercise physiologist who has helped me.  It is important to have a suitably qualified personal trainer who has experience with osteopenia and osteoporosis, as with weakened bones we need to ensure we lift safely. Also to not only stay within our limits, but to be always increasing over time to ensure that the bones continue to receive the adequate stress to stimulate bone regrowth. 

Conclusion

By nourishing your body with the right foods and nutrition and maintaining an active lifestyle through yoga and weights, can help prevent osteopenia and osteoporosis during menopause. 

After just 4 months of weightlifting at the time of writing this,  I have put on significant muscle mass, with an increase of 5 kg, and this strength is now supporting my asana yoga practice which in turn continues to build strength, good posture, flexibility and relaxation. 

Remember, it’s never too late to start taking care of your bones! We can prioritise a range of  weight-bearing exercises and include bone-nourishing foods in our diet, and take time to rest and manage stress for holistic bone health both now and into the future.

If you would like to learn more about my yoga for menopause offers check out my upcoming menopause yoga workshops and Wise Women in Menopause Retreat 2-4 May, 2025.

And please reach out if you have any questions about this blog or menopause yoga in general. I’d love to help in any way I can. 

Bibliography

Fishman, L. Saltonstall, E. (2010) Yoga for Osteoporosis. WW Norton.

Porter, M. (2022) Yoga for Menopause Wellbeing Training Manual. Unpublished.