As women age, certain physiological changes make them more vulnerable to hip fractures.
While this risk is well documented, it’s often overlooked in everyday health discussions—particularly when the symptoms appear subtle or unrelated at first glance. Understanding what contributes to this increased risk is key to prevention and long-term mobility.
Hormonal changes and bone health
One of the most significant factors is the decline in oestrogen following menopause. This hormonal shift accelerates bone density loss, making the bones more fragile and prone to fracture. According to the International Osteoporosis Foundation, 1 in 3 women over the age of 50 will experience a fragility fracture.
In the UK, hip fractures are among the most serious of these injuries—often requiring surgery, hospitalisation, and a lengthy period of recovery.
The role of muscle strength and physical stability
Alongside changes in bone density, age-related muscle loss (sarcopenia) can reduce strength and balance. A less stable gait or slower reflexes can increase the likelihood of falling—a major cause of hip fractures in older adults.
Exercise that promotes muscle strength, balance, and flexibility plays a crucial role in minimising these risks. Programmes aimed at fall prevention have shown significant benefits, particularly for older women.
Pelvic-floor weakness: an under-recognised contributor
Conditions like urinary incontinence and pelvic-floor weakness, which affect many women post-menopause, may indirectly increase the risk of falls. While not a direct cause of fracture, these conditions are often linked to reduced mobility, lower core strength, and decreased physical confidence.
A study in Aging Clinical and Experimental Research highlighted that older women experiencing both incontinence and mobility issues have a higher incidence of falls, which can lead to fractures—especially when bone health is already compromised.
Why proactive care matters
It’s not uncommon for women to delay seeking care for symptoms they perceive as “normal” with ageing. However, early attention to pelvic-floor symptoms, bone health, and physical strength can greatly reduce the likelihood of future complications.
Steps that can make a difference:
• Bone density scans (DEXA) to assess osteoporosis risk
• Strength and balance exercises as part of weekly routines
• Pelvic-floor physiotherapy when indicated
• Adequate calcium and vitamin D through diet or supplementation
• Regular check-ups, especially if there is a personal or family history of fractures
Final note
Hip fractures are not inevitable. By understanding the physiological changes that occur with age—and addressing them proactively—women can maintain independence, reduce injury risk, and continue to lead active lives well into older age.