Bone is living tissue, constantly broken down and rebuilt. Oestrogen slows the breaking-down side, which is why its decline around menopause tips the balance.
Most women lose bone density fastest in the few years either side of their last period. The loss is silent — the first sign is often a fracture from a fall that should not have caused one.
Weight-bearing and resistance exercise are the most consistently supported interventions, because bone responds to load. Walking helps; lifting something helps more.
Adequate calcium and vitamin D matter, but supplementing beyond sufficiency does not add benefit. Smoking and heavy drinking both accelerate loss.
Whether to consider a bone density scan or medication depends on individual risk — family history, early menopause, certain medications and previous fractures all shift it. That is a conversation worth having before a fracture rather than after.