Why does bone loss accelerate around menopause?

Bone loss accelerates around menopause primarily due to the significant decline in the production of estrogen and other sex hormones.12

During a woman's reproductive years, estrogen plays a vital role in maintaining skeletal health by suppressing bone resorption—the process by which bone tissue is broken down and assimilated. When estrogen levels drop sharply at the onset of menopause, this inhibitory effect is lost, leading to an imbalance where the rate of bone resorption exceeds the rate of new bone formation. This shift results in a period of accelerated bone loss that typically occurs during and for several years after menopause, significantly increasing the risk of osteopenia and osteoporosis.3214

While this hormonal change is a primary driver, other factors such as physical inactivity, nutritional deficiencies (particularly in calcium and vitamin D), and smoking can further contribute to the reduction in bone density.24