Will vitamin D supplements improve my bone strength?

Not as long as you’re already getting the recommended daily allowance (600 IU) through the foods you eat and direct sunlight. Recent research found that high doses of vitamin D don’t increase bone density in healthy adults (aged 55 to 70 years), and it may even decrease it, although that needs more research. If you live in an area that doesn’t get a lot of sun for long stretches of the year, you may need to take a supplement to get the recommended amount.

Bone health is a major issue for menopausal women, and it often gets overlooked. In one of our recent Fullness of Midlife interviews, Dr. Avrum Bluming, who co-authored Estrogen Matters, said, “In the United States and throughout most of the western world, the number of women who died within a year of a hip fracture is about the same as the number of women who die of breast cancer. That is often ignored, and it shouldn’t be.”

While calcium strengthens the outer bone, it doesn't help the osteoid.

So here’s a recap of what does and doesn’t help with bone strength after menopause. The biggest misconception has to do with calcium. While calcium does strengthen the outer shell of the bone, it doesn’t help the osteoid—the collagen fibers inside the bone that allow it to flex without breaking. Calcium supplements don’t guard against fractures because they don’t help the bone’s resilience.

Bisphosphonates like Fosamax improve bone density but won’t reverse osteoporosis once you

have it, and not every woman can tolerate them.

Hormone therapy does work. Estrogen significantly reduces the risk of hip fracture,

perhaps by as much as 50 percent, according to multiple studies. Osteoporosis is a chronic

condition, and I think women need to be as proactive about their bone health as much as they are about their breast health. Because the most rapid bone loss occurs in the first five years of menopause, hormone therapy should start as soon as possible once you hit menopause. Also, hormone therapy benefits the bones only for as long as it is being taken. 

Each woman has her own risk factors, symptoms, and preferences. I encourage you to talk to a knowledgeable professional about how you can best protect your own bone health.