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Aging Gracefully

A Decade-by-Decade Guide to Protecting Your Bones

Take a stand: what you should (and shouldn’t) do to avoid breaks, fractures, and bone loss throughout your lifetime.

By Stacey Colino
Illustration of a girl with X-raysSophie Blackall

In Your 20s

  • Be watchful of weight watching. If you’re dieting, be sure to exercise, too. Studies show that dieting without exercise can lead to bone loss.
  • Exercise smartly. Regular exercise that puts pressure on your bones (20 to 30 minutes a day is ideal), such as running and lifting weights, will help preserve bone density by encouraging the formation of osteoblasts. But don’t overdo it: If you exercise excessively, your period can become irregular or cease, which may increase your risk of premature bone loss.
  • Pay attention to your periods. Infrequent periods (fewer than six to eight a year) are associated with low estrogen levels and often with low body weight, “which can be a double whammy for bones,” says Felicia Cosman, M.D., the clinical director of the National Osteoporosis Foundation and a professor of medicine at Columbia University. Estrogen is your bones’ best ally because it tends to slow the rate of bone loss. So if you’re not having regular periods, speak with your gynecologist.
  • Think carefully about contraception. The estrogen in oral contraceptives may increase bone mass. But using Depo-Provera, the once-a-month injectable contraceptive, for more than two years has been shown to suppress estrogen production and lead to bone loss in young women, Cosman warns.


In Your 30s

  • Protect your bones during pregnancy. If you skimp on calcium while pregnant, your growing baby will take the calcium it needs from your bones. But if you get the recommended 1,000 milligrams a day, your body will absorb even more of the bone-fortifying mineral than usual. Afterward, breast-feeding for more than a year can adversely affect your bones, Cosman says, “but bone mass, for the most part, can be regained later if you get the requisite amount of calcium and vitamin D.”
  • Identify risky medications. The use of corticosteroids (to treat asthma, inflammatory bowel disease, rheumatoid arthritis, or lupus), anticonvulsants (for seizure disorders), or GnRH agonists (for endometriosis) can lead to fairly rapid bone loss, says David Hamerman, M.D., the director of the Center for Bone Health at Montefiore Medical Center, in New York City. High doses of proton pump inhibitors, which are used to treat acid reflux, may harm bones by interfering with the absorption of calcium. If you are taking one of these medications, consult with your doctor. She might choose to put you on bisphosphonates, a type of drug that counteracts bone loss, says Hamerman.
  • Get a grip on stress. Stress hormones, like cortisol, can inhibit bone growth and accelerate bone breakdown. Depression can have similarly harmful effects on bones.
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