Most of us accept that our bodies will change as we get older.
Perhaps you've noticed it yourself. A few more aches and pains. Less strength than you once had. Recovery takes longer. Activities that used to feel effortless suddenly require a bit more thought.
But while ageing happens to all of us, it doesn't happen in the same way.
When it comes to your muscles, bones, joints and spine, men and women experience ageing differently. Hormones, muscle loss, bone density and even how we experience pain all play a role. Understanding these differences can help you make informed decisions about your health and take positive steps before small problems become bigger ones.
Bone Health: A very different story for men and women
Osteoporosis, a condition that causes bones to become thinner and weaker, affects both men and women. However, the speed and scale of bone loss can be very different.
For women, menopause is often the defining moment.
As oestrogen levels fall, the balance between bone formation and breakdown shifts. The cells responsible for bone breakdown become more active, while those that build new bone struggle to keep pace. As a result, women can lose up to 20% of their total bone mass around menopause, with some losing 10–20% within just five to six years.
This is why osteoporosis is so common after menopause. Around one in two postmenopausal women will develop the condition, and one in three women over the age of 50 will experience an osteoporotic fracture during their lifetime. Fractures of the spine and hip are particularly concerning because of their impact on mobility, independence and overall health.
Men lose bone too, but generally at a slower rate. They do not experience the same sudden hormonal shift and typically start adulthood with greater bone mass, giving them a larger reserve. However, bone health in men is often overlooked. As a result, osteoporosis is frequently diagnosed later, and osteoporosis-related fractures in men are associated with higher mortality rates than in women.
The message is clear: bone health matters for everyone, not just women.
Muscle Loss: One of the biggest changes of ageing
We often focus on our joints as we get older, but one of the most significant changes actually happens in our muscles.
Age-related muscle loss, known as sarcopenia, affects strength, mobility, balance and independence. By their 70s, most people have lost around 25–30% of the muscle mass they had in their 20s, while muscle strength typically declines even further. After the age of 50, muscle mass decreases by around 1–2% each year.
Again, the causes differ between men and women.
For men, testosterone gradually declines from around their 30s onwards. Because testosterone helps maintain muscle tissue, lower levels can slow muscle metabolism and increase the risk of sarcopenia. Men typically lose more muscle overall, and the effects on strength, walking speed and coordination can become increasingly noticeable over time.
For women, menopause marks another important turning point. Oestrogen helps support muscle health, and when levels drop, muscle loss often accelerates. At the same time, body fat tends to increase, making everyday movements and activities more challenging. Older women are more likely than men of the same age to experience difficulties with tasks such as getting up from a chair or moving around the home.
Interestingly, while sarcopenia is less common in women overall, when it does develop it is associated with higher mortality rates. This makes maintaining muscle health an important priority for both men and women.
Pain: Different experiences, different challenges
Pain isn't experienced equally either.
Women are more likely to experience musculoskeletal (MSK) conditions such as low back pain, neck pain, osteoarthritis and fibromyalgia. They also tend to report pain in more areas of the body, have longer-lasting symptoms and experience greater sensitivity to pain. Biological differences in pain processing, hormones and inflammation all contribute to these patterns.
Women can also face another challenge: their symptoms are more likely to be attributed to psychological causes rather than physical ones, and research suggests they are often under-prescribed pain medication relative to what they report experiencing.
Men, on the other hand, often face the opposite problem.
Many men delay seeking help, hoping symptoms will improve on their own or believing they should simply push through discomfort. The consequences can be significant. Research shows men are more likely to take time off work or retire early because of MSK conditions that have progressed before treatment is sought.
While the reasons differ, the outcome is often the same: musculoskeletal problems are picked up later than they should be.
What About the Spine?
The spine sits at the centre of many of the changes associated with ageing.
For women, bone loss in the vertebrae increases the risk of compression fractures and kyphosis, the forward rounding of the upper back. For men, the gradual loss of muscle that supports the spine, combined with years of physical loading, can contribute to chronic low back pain.
For both sexes, maintaining spinal mobility, preserving muscle strength and managing the stresses placed on the body over time becomes increasingly important.
Chiropractors can play a role in supporting spinal function and mobility as the body changes with age. Not as a treatment for osteoporosis or sarcopenia themselves, but as part of a broader approach to staying active, moving well and managing musculoskeletal health over the long term.
What Can You Do?
The good news is that many of the biggest age-related changes affecting muscles, bones and the spine are not simply things that happen to us. They're things we can influence.
For Women
- Consider bone density screening, such as a DEXA scan, from perimenopause onwards rather than waiting until a fracture occurs.
- Make resistance training a regular part of your routine. It helps build and maintain both bone and muscle strength.
- Prioritise good nutrition, including sufficient calcium, vitamin D and protein.
- Pay attention to posture and spinal health as the protective effects of oestrogen decline.
For Men
- Remember that a slower decline is still a decline. Muscle loss and spinal degeneration can develop gradually and go unnoticed for years.
- Combine strength training with regular cardiovascular exercise for the best protection against age-related physical decline.
- Seek help early for back pain, joint pain or reduced mobility rather than waiting until symptoms become severe.
For Everyone
- Keep moving. Regular physical activity remains one of the most effective ways to support musculoskeletal health.
- Prioritise sleep, nutrition, stress management and overall wellbeing, all of which influence how your muscles, bones and joints function.
- Look for personalised support. There is no one-size-fits-all approach to healthy ageing. Biological differences, lifestyle and individual circumstances all matter.
The Bottom Line
Men and women age differently. Hormones, muscle loss, bone health and pain all influence how our bodies change over time.
The encouraging part is that many of the biggest risks associated with ageing, including osteoporosis, sarcopenia and spinal decline, are things we can act on. The earlier we understand what's happening in our bodies, the better equipped we are to protect our health in the years ahead.
Ageing is inevitable. Giving your body the best chance to stay strong, mobile and resilient is not.
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