Why are calcium and vitamin D so important during menopause?

If you grew up in the ‘90s, you probably remember the “Got Milk?” ads featuring milk-mustached celebrities. Beyond dairy marketing, the goal was to promote the intake of calcium and vitamin D — two nutrients vital for bone health. While they’re often associated with childhood growth, they’re just as important for women going through menopause.

Calcium is the most abundant mineral in the body. It builds and maintains strong bones, while also helping muscles, nerves, and the heart function properly. The body can’t make calcium, so it must come from food or supplements. When intake is low, the body pulls calcium from bones—weakening them over time.

Vitamin D helps the body absorb calcium and plays roles in immune support, inflammation control, and muscle health. Adults who don’t get enough vitamin D risk developing osteoporosis, a condition that causes brittle bones. Unlike calcium, the body can make vitamin D—but only with adequate sunlight exposure.

Hormonal changes during menopause accelerate bone loss. "Estrogen helps slow the natural breakdown of bone, and it supports the activity of cells that build bone," says Dr. Rachael Lopez, OB/GYN and medical director at MemorialCare Saddleback Medical Center in Laguna Hills, CA. “When estrogen levels drop, bone loss speeds up, raising the risk of osteoporosis.”

Women over 50 should aim for 1,200 mg of calcium per day. Adults up to age 70 need 600 IU of vitamin D, and those over 70 should get 800 IU daily.

For perspective, per the USDA’s database, 8 ounces of nonfat milk offers about 325 mg of calcium and 108 IU of vitamin D (if fortified).

You don’t need to rely on milk alone. Other great sources of calcium include:

• Yogurt (plain, low fat): 415 mg per 8 oz

• Tofu (firm, calcium-set): 253 mg per half-cup

• Canned sardines: 325 mg per 3 oz

• Kale (raw, chopped): 24 mg per cup

Some foods are fortified with calcium:

• Soymilk: 299 mg per cup

• Orange juice: 349 mg per cup

Vitamin D is harder to get from food. Your best bet? Sunlight.

“You only need about 10 to 20 minutes of sun per day,” says Dr. Michael Holick, professor of medicine at Boston University. He recommends exposing arms, legs, or shoulders—rather than your face—to minimize skin cancer risk. Afterward, apply sunscreen.

“Many women fall short through food alone, especially if they avoid dairy or get limited sun,” says Ali McGowan, R.D., a Boston-based dietitian. Supplements can help fill in the gaps.

• For calcium, choose one with calcium carbonate (about 500 mg/day).

• For vitamin D, opt for 10 mcg (400 IU) paired with vitamin K2, which helps transport calcium into bones.

Look for third-party tested brands with seals from NSF or USP, and always check with your healthcare provider first.

Vitamin D is fat-soluble, so take it with meals that include healthy fats—like eggs, avocado, or salmon. “Avoid pairing calcium with high amounts of caffeine, which can block absorption,” says McGowan.

You may not notice symptoms of low calcium or vitamin D right away. But issues like muscle cramps, tingling in fingers and toes, brittle nails, fatigue, and muscle aches can all be signs.

“Talk to your doctor about bone loss due to menopause, even if you don’t have symptoms,” says Lopez. A simple blood test can measure vitamin D levels, and your provider can recommend a supplement plan if needed.