Exercise and bone health in perimenopause and menopause
Exercise is one of the most important things you can do for your bones during perimenopause and menopause. Resistance training helps. Impact activity helps. Combining both produces the strongest results. All of it counts, and none of it has to look the same for every woman.
What the research shows
The research on exercise and bone health has been building for decades, and the picture is encouraging. Women who do resistance training regularly, exercises that work your muscles against some form of load like weights, bands or your own bodyweight, maintain better bone density than those who do not. Adding impact activity, things like brisk walking, jogging, jumping or dancing, makes that effect even stronger.
Exercise will not stop bone loss completely. What it does is slow the process down and reduce your risk of fracture over time. Starting during perimenopause gives you the best opportunity, though it is never too late to begin.
What counts as resistance training
Resistance training is any exercise where your muscles are working against some form of load. That might be weights at a gym, resistance bands at home, your own bodyweight, or a Pilates or yoga class that includes strengthening work. It does not have to be heavy and it does not have to be in a gym.
Progressive load matters
The research is clear that gradually increasing the challenge over time is what drives the bone benefit. That does not mean you need to lift heavy from the start. It means starting at a level that feels manageable and building from there, whether that is adding more resistance, more repetitions, or more difficulty over weeks and months. Your body adapts to what you ask of it, and that adaptation is what protects your bones.
Training to failure is not necessary
Some women are told they need to train to exhaustion or failure to get results. The evidence does not support that for bone health or muscle strength in this life stage. Working hard matters. Working to the point where your technique breaks down or you cannot recover does not add benefit and increases your risk of injury.
Lifting is one part of a bigger picture
Resistance training is important, and so is impact activity for your bones. What often gets left out of the conversation is that your body needs more than that. Cardiovascular fitness, flexibility, mobility and balance all matter for how you feel and function during perimenopause and menopause. A varied approach to movement serves you better than any single type of exercise alone.
What if a gym is not an option
Not every woman wants to go to a gym, and that is completely valid. Cost, access, confidence, time, there are many reasons a gym might not be the right fit right now.
Brisk walking, stair climbing, dancing, carrying shopping, these all count. Resistance bands are inexpensive and work well at home. Your own bodyweight is enough to get started.
The best exercise for your bones is the one you can actually do consistently. Starting somewhere, even with small amounts of movement, is better than waiting for the perfect conditions.
Pelvic health and exercise
Something that rarely comes up in the bone health conversation is your pelvic floor. It is affected by the same estrogen changes affecting your bones and muscles, and it responds to the same exercises that are recommended for bone health.
Heavy lifting and high impact activity increase the load on your pelvic floor. That does not mean avoiding them. It means being aware of how your body responds. If you notice any leaking, heaviness or pressure in your vagina during or after exercise, that is worth getting some support for before you progress your load. The National Continence Helpline on 1800 33 00 66 is free and a good place to start.
References
Howe, T.E., Shea, B., Dawson, L.J., Downie, F., Murray, A., Ross, C., Harbour, R.T., Caldwell, L.M., & Creed, G. (2011). Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database of Systematic Reviews, 7, CD000333. https://doi.org/10.1002/14651858.CD000333.pub2
Kemmler, W., Bebenek, M., Kohl, M., & von Stengel, S. (2015). Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporosis International, 26(10), 2491–2499. https://doi.org/10.1007/s00198-015-3165-3
Mohebbi, R., et al. (2023). Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis. Osteoporosis International, 34, 1145–1178. https://doi.org/10.1007/s00198-023-06682-1
RACGP and Healthy Bones Australia. (2024). Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age. Royal Australian College of General Practitioners.
Watson, S.L., Weeks, B.K., Weis, L.J., Harding, A.T., Horan, S.A., & Beck, B.R. (2019). High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research, 34(3), 475-485. https://doi.org/10.1002/jbmr.3659
Wright, V.J., Schwartzman, J.D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466-472. https://doi.org/10.1080/13697137.2024.2380363
WHEN Position Statement: Resistance Training Across the Menopausal Transition (April 2026). Women’s Health Education Network. www.when.org.au
Developed by the WHEN Clinical Team
Clinically reviewed by the WHEN Clinical Governance Committee
Last reviewed: July 2026
