Detailed definition
Calcium is the most abundant mineral in the body, with 99% stored in bones and teeth. Postmenopausal women experience increased bone resorption from estrogen withdrawal, raising calcium requirements. The Institute of Medicine recommends 1200 mg/day for women over 50; many menopause societies suggest 1000–1200 mg total intake. Food sources (dairy, leafy greens, fortified products, sardines with bones) are preferred over supplements because they are absorbed more gradually and have not been linked to the cardiovascular concerns seen with high-dose supplements in some observational data. When supplementation is needed, calcium citrate is generally better tolerated than calcium carbonate and does not require gastric acid for absorption (relevant for women on PPIs). Total intake exceeding 2000 mg/day has been associated with increased kidney stone risk and possibly cardiovascular concerns in some studies.
Why it matters in menopause
For most postmenopausal women, dietary calcium adequacy plus vitamin D adequacy is the foundation. Supplementation should fill specific gaps rather than blanket high-dose strategies.