Start Bone Support Early in Perimenopause
Start Bone Support Early in Perimenopause
Proactive bone health management during perimenopause can significantly impact long-term fracture risk, as accelerated bone loss begins 2-3 years before the final menstrual period— often while women are still having regular cycles. This early intervention window is crucial yet frequently overlooked.
Vitamin D status deserves particular attention, with research showing that approximately 42% of perimenopausal women have insufficient levels (<30 ng/mL), compromising calcium absorption and bone mineralization. The Endocrine Society recommends that women in midlife maintain levels between 30-50 ng/mL, often requiring supplementation of 1000-2000 IU daily, though individual needs vary based on geographic location, skin tone, sun exposure habits, and genetic factors affecting vitamin D metabolism. Annual or biannual testing allows for personalized dosing adjustments.
Vitamin K2 (specifically the MK-7 form) has emerged as an important complementary nutrient, directing calcium toward bone rather than arterial tissue. Research demonstrates that supplementation with 180mcg daily of vitamin K2 (MK-7) significantly reduced bone loss in postmenopausal women compared to placebo over a three-year period.
While calcium supplements remain controversial due to potential cardiovascular concerns, food-based sources are universally recommended. For women unable to consistently consume 1000-1200mg daily through diet, smaller supplement doses (500mg or less) taken with meals may bridge the gap with minimal risk. Women with family history of osteoporosis or additional risk factors like small frame, smoking history, or corticosteroid use should consider baseline bone density testing during perimenopause rather than waiting until after menopause to establish early intervention strategies.
Sources:
Knapen MH, Drummen NE, Smit E, Vermeer C, Theuwissen E. Three-year low-dose menaquinone7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporosis International: A Journal Established as a Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2013;24(9):2499-2507.
LeBoff MS, Chou SH, Murata EM, et al. Effects of supplemental vitamin D on bone health outcomes in women and men in the VITamin D and OmegA-3 TriaL (VITAL). Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research. 2020;35(5):883-893.
