If you’re postmenopausal and just learned you have osteoporosis, you’re far from alone. Osteoporosis affects nearly 20 percent of women ages 50 and up in the United States. And by age 65, as many as 1 in 4 women have osteoporosis.

There are a few reasons for this. As we age, our bodies generally have a harder time producing bone. Also, estrogen helps protect bone density, and there’s a big drop in estrogen after menopause, which typically begins between ages 45 and 55.

While common, postmenopausal osteoporosis can cause serious health effects. Weakened bones can easily fracture and break, leading to mobility challenges, reduced quality of life, and potentially death.

But there are steps you can take to strengthen your bones and slow the progression of this disease.

With that in mind, here are some things to ask your doctor about postmenopausal osteoporosis.

Hormone therapy with estrogen alone or with estrogen plus progesterone is often used to ease symptoms of menopause, but it can also help prevent bone density loss.

It’s not for everyone, though. Hormone therapies may raise the risk of:

  • blood clots
  • heart attack and stroke
  • breast cancer
  • gallbladder disease

To see if hormone therapy is right for you, talk with a doctor. They can provide an individual assessment of your health and explain the risks and benefits of this treatment.

There’s no single management plan for osteoporosis, so it’s worth exploring a variety of strategies to protect your bones and minimize the progression of this disease. Here are some ways to improve your bone health:

  • Stay active. Create an osteoporosis-friendly exercise routine that includes resistance, balance, and weight-bearing activities. This can help keep your bones strong and reduce the likelihood of falling.
  • Get calcium. Women age 51 and older typically need about 1,200 milligrams (mg) of calcium per day. If you don’t get enough calcium in your diet, your body may take it from your bones, which can weaken them. Incorporating foods like milk, cheese, yogurt, leafy green veggies, and fortified products (like cereals, pastas, and soy) into your diet can help you get the recommended amount of calcium. Your doctor may also recommend a calcium supplement.
  • Get vitamin D. Vitamin D helps the body absorb calcium from food, so it’s important to make sure you’re getting enough of it. Women up to age 70 need about 600 international units (IU) of vitamin D per day, while those age 71 and up need 800 IUs. Getting 10 to 15 minutes of sun exposure a few times each week can help your body produce an adequate amount of vitamin D. Salmon, tuna fish, and egg yolks also contain vitamin D.
  • Avoid smoking. Smoking tobacco products has been linked with decreased bone density, higher risk of fractures, and a negative impact on healing after a fracture. If you smoke, finding ways to cut back or quit altogether could help reduce your risk of bone loss.
  • Limit alcohol consumption. Drinking high levels of alcohol can be bad for your bones. When you’re impaired, you may also be at a higher risk of bumps and falls, which can lead to fractures. The Centers for Disease Control and Prevention (CDC) recommends that women consume no more than one drink per day.

Your doctor may also provide other strategies for reducing the effects of osteoporosis based on factors such as your:

  • age
  • co-existing health conditions
  • current medications
  • history of fractured bones

While staying active is an important part of overall health, certain activities may not be safe if your bones are weak. Those with low bone mass should typically avoid moves that flex, bend, or twist the spine. High-impact exercises can also increase the risk of breaking a bone.

That doesn’t mean you should avoid exercise altogether, though. Weight-bearing and muscle-strengthening exercises in particular play an important role in building and maintaining bone density.

And activities such as yoga or tai chi may help improve balance, which can lower the risk of injury due to falling.

While some activities may be off-limits if you have osteoporosis, others can be done safely with some modifications. For example, you may be to continue hiking by using trekking poles or a walking stick to say balanced and avoiding steep mountain trails.

Talk with your doctor about the do’s and don’ts of exercising with postmenopausal osteoporosis and ways to stay safe during your workouts.

Your doctor can advise on whether you would benefit from an assistive device, such as a cane or walker, that can help you stay stable and avoid falls.

If they’re medically necessary and you have a prescription, these devices may even be partially covered by Medicare or your insurance.

Ask for information on other ways to lower risk, such as:

  • installing handrails in the home
  • placing grab bars in your shower
  • wearing supportive shoes
  • removing trip and fall hazards in the home

Other aspects of your health, such as medications you’re taking and any other conditions you’re managing, could affect your bone health.

Make sure your doctor is aware of conditions you have that may affect the skeleton, such as:

  • rheumatoid arthritis
  • diabetes mellitus
  • Cushing syndrome
  • inflammatory bowel disease (IBD)
  • celiac disease
  • chronic kidney or liver disease
  • eating disorders

It’s also important to discuss your current medications with a health professional to see if they’re affecting your osteoporosis. Some drugs that can cause bone loss include:

  • aromatase inhibitors
  • excess thyroid hormones
  • immunosuppressants
  • glucocorticoids
  • anticonvulsants

While there’s no cure for osteoporosis, a variety of treatments can help protect and strengthen your bones. These include:

  • Bisphosphonates: A group of drugs that treat bone loss and may help improve bone mass.
  • Selective estrogen receptor modulators (SERMs): These medications work to slow postmenopausal bone loss by mimicking the effects of estrogen on bone density.
  • Hormone therapy: Used to treat symptoms of menopause as well as postmenopausal osteoporosis.
  • Parathyroid hormone: These injectable medications, which include teriparatide and abaloparatide, help the body build new bone and reduce the risk of fractures.
  • Denosumab: Treats those who are past menopause and at high risk of broken bones.
  • Calcitonin: A hormone produced by the thyroid gland that helps regulate calcium and build bone mass.
  • Romosozumab: Helps to boost bone formation and reduce bone resorption.

The best treatment for you depends on a variety of factors, such as your bone density test results, risk of fracture, and other health conditions you may have.

Talk to your doctor about which osteoporosis treatment may be most promising for you. You may want to ask:

  • Which medications are most likely to improve my bone health?
  • How do these medications work?
  • How will I take them and how often?
  • What are the potential side effects and risks?

Getting the proper amounts of calcium and vitamin D can provide important benefits to your bones. In many cases, you may be able to get enough of these nutrients through your diet and, in the case of vitamin D, sun exposure.

If you’re not getting adequate calcium and vitamin D, a supplement may help. However, you should talk with a health professional before adding a supplement to your regimen. They can advise on whether a supplement is safe for you and what dose you should take.

You probably had a bone density test prior to receiving an osteoporosis diagnosis. You may need to get additional bone density tests to determine whether your osteoporosis treatment is helping or you’re still experiencing bone loss.

Just how often you should test depends on the severity of your bone loss. Talk with your doctor about how frequently you’ll need to undergo bone density tests.

If you’ve received a diagnosis of postmenopausal osteoporosis, keeping an open dialogue with your doctor can help you manage the condition and reduce the risk of complications. You may want to ask about:

  • osteoporosis treatments, including hormone therapy
  • preventing osteoporosis from worsening
  • exercising safely
  • reducing the risk of fractures
  • your other conditions and medications
  • taking supplements
  • scheduling bone density tests

Osteoporosis has no cure, but getting proper treatment and making changes to your diet and lifestyle can help reduce the impact this condition makes on your life. Talk with your doctor about the right osteoporosis management plan for you.