Women Over 45: Your Health, Hormones, and Bones Deserve More Attention Than Ever

I didn’t think I had to worry about my bones. The same for my friends. We are all in our mid to late 50s, active, and fit. But when my doctor suggested a DEXA scan—a test I’d thought was for older women—I was shocked to learn I had osteopenia, the early stage of bone loss.

That wake-up call changed the way I think about aging. If you’re a woman over 45, I’m here to tell you: You may feel fine, but your body could be changing in ways you can’t see. And if you ignore those changes, the consequences could impact not just your health—but your independence.

Osteoporosis is a disease that weakens bones, making them porous, brittle, and more likely to break—even from simple movements like bending or coughing. Osteopenia, what I have, is the early stage of bone loss, when bone density is lower than normal but not yet low enough to be classified as osteoporosis.

Both conditions often develop without symptoms, which is why routine screening—especially for women over 45—is essential for early detection and prevention.

5 Actions You Can Take To Prepare for Midlife Changes

These five health priorities matter more than ever. They’re not about chasing youth. They’re about protecting your future independence and quality of life.

1. Nutrition: Eat With Your Bones and Hormones in Mind

Don't ignore the risk of osteoporosis. By midlife, your body becomes less efficient at absorbing nutrients, and hormonal shifts can accelerate bone loss and weight gain. A healthy diet now serves as armor for your heart, your muscles, and your skeleton.

Focus on:

• Calcium-rich foods like leafy greens, yogurt, almonds, and tofu
• Vitamin D (from sunlight, fortified foods, or supplements)
• Magnesium and vitamin K2, which help support bone metabolism
• Lean proteins, whole grains, and healthy fats like olive oil

The Mediterranean diet—widely backed by research—offers balanced, nutrient-dense meals that support energy, weight, and bone strength.

2. Exercise: Build Strength to Stay Independent

Movement isn’t just about burning calories—it’s about protecting your mobility.

Women lose up to 30% of muscle mass between the ages of 50 and 70, making strength training essential. Add weight-bearing and balance exercises to help prevent osteoporosis-related fractures and falls.

Recommended weekly activity:

• 150 minutes of moderate aerobic activity (walking, swimming, cycling)
• 2+ days of muscle-strengthening exercises
• Balance-focused movement like tai chi or yoga

Strength training is one of the most powerful tools women have to remain independent as they age.”

Lifting weights contributes to bone health, prevents osteoporosis, and helps maintain muscle mass as we age. — Dr. Pamela Peeke, The Dangerous Women Podcast.

Some doctors recommend natural treatment for bone density for some patients. Find a natural treatment for osteoporosis without medication. However, lifestyle alone can't treat osteoporosis, although it can be beneficial if you have osteopenia. Medical consensus is that while helpful, these interventions mainly prevent further loss and often complement, not replace, pharmacologic therapies.

3. Bone Health: Don’t Assume You’re Safe—Test and Protect

Bone loss can be invisible until it’s serious. That’s why a DEXA scan is one of the most important preventive steps you can take in your 40s or 50s.

A DEXA (dual-energy X-ray absorptiometry) scan:

• Takes about 15 minutes
• Measures your bone density at the hips and spine
• Provides a T-score, which helps diagnose osteoporosis or osteopenia
• It is covered by Medicare and most private insurers if you have risk factors

T-score ranges:

• –1.0 or above: Normal
• –1.0 to –2.5: Osteopenia
• –2.5 or below: Osteoporosis

Dr. Andrea Singer, chief medical officer of the Bone Health & Osteoporosis Foundation, points out that many women don’t realize they have osteoporosis until a fracture occurs—and that once one fracture happens, the risk of another increases significantly.

Remember, the first fracture often leads to a second. Early detection is critical.

Why it matters: Fractures from osteoporosis are a leading cause of long-term care admissions. One in five women over 65 will suffer a hip fracture, and many never regain full independence.

Since long-term care costs are not paid for by health insurance, including Medicare, outside of 100 days of skilled services, the impact of osteoporosis on your family and finances can be considerable unless you have prepared in advance.

Planning with Long-Term Care Insurance helps ensure you can afford the quality extended care you want—at home or in a facility—if you ever lose mobility or need daily assistance.

Use the LTC News Cost of Care Calculator to see care costs where you live. If you have a loved one who requires long-term care services now, search for the best providers, both in-home care providers and long-term care facilities, with the LTC News Caregiver Directory.

4. Mental and Emotional Health: Midlife Deserves Support Too

Perimenopause and menopause aren’t just physical—they bring emotional and cognitive shifts too. Mood swings, anxiety, insomnia, brain fog, and depression are common—and treatable.

Ways to protect your mental health:

• Prioritize sleep hygiene and stress reduction
• Speak with your doctor about hormonal or non-hormonal therapy
• Stay connected—social isolation increases dementia risk
• Don’t hesitate to seek therapy or support groups

According to the North American Menopause Society, emotional symptoms of menopause are often dismissed or misdiagnosed, even though they have a real biological basis.

Taking care of your mind is just as important as caring for your heart or bones—because stress and depression can take a serious toll on your physical health and long-term function.

5. Life Balance and Long-Term Planning: Be Intentional

You can’t stop aging, but you can manage how it affects your life.

This is the time to ask:

• How do you want to age?
• Would you prefer to stay in your home with assistance—or move to a community with more social support?
• Who would help you if you could no longer dress, bathe, or manage medications?
• How would you pay for long-term care services if you don't have Long-Term Care Insurance?
• How long would your money last, and could loved ones quit their jobs and become full-time caregivers?

Too many women wait until a crisis—like a fracture or illness—forces urgent decisions. But planning now gives you control and peace of mind.

If you or a loved one has Long-Term Care Insurance, the policy helps pay for:

• In-home care
• Assisted living
• Memory care
• Nursing facilities

It also protects your retirement income and savings and reduces the burden on your adult children. But coverage is most affordable—and available—when you’re healthy and planning ahead.

Take Charge of Your Health—And Your Future

This phase of life brings change. But it also brings opportunity—to care for yourself differently, more fully, and more intentionally.

Start with a conversation with your doctor. Ask about a DEXA scan. Build strength. Nourish yourself. Support your mind. Make a care plan that reflects your values and protects your independence. 

Aging doesn’t mean giving up control. It means choosing how you want to live now and later.

Trusted Resources for Women’s Midlife Health and Long-Term Care

• LTC News Cost of Care Calculator – Research current and future care costs in your area
• Bone Health & Osteoporosis Foundation – Education, prevention, and support for bone health
• National Institute on Aging – Government research on osteoporosis, menopause, and aging
• North American Menopause Society – Expert resources and treatment guidelines
• Centers for Disease Control and Prevention – Fall prevention and fracture risk in older adults
• Medicare.gov – Bone Mass Measurement – Eligibility and coverage for DEXA scans
• LTC News – In a partnership with Amada Senior Care, LTC News offers free processing of Long-Term Care Insurance claims.