Strong Bones for Life: Bone Health at Every Age

We talk a lot about heart health, blood pressure, cholesterol, and cancer screening—but bone health sometimes gets overlooked until there’s a problem. The good news is that there’s a lot we can do throughout our lives to build strong bones, slow bone loss, and prevent fractures as we get older.

Start Building Strong Bones Early

Think of childhood, adolescence, and young adulthood as the time we’re making deposits into our “bone bank.” We reach our peak bone mass in early adulthood, but taking care of our bones remains important at every age.

The basics aren’t complicated. Weight-bearing exercise—walking, hiking, running, dancing, tennis, and similar activities—helps maintain bone strength. Even better? Add strength training a few times a week. Resistance exercise strengthens both bones and muscles, while balance work can help prevent falls later in life.

Nutrition matters too. Calcium is an important building block for bone, and vitamin D helps us absorb it. Whenever possible, aim to get calcium through foods like dairy products, fortified foods, leafy greens, tofu, and canned salmon or sardines. Adequate protein is important too. Avoiding smoking and limiting excessive alcohol also help protect your bones.

Menopause Deserves Special Attention

For women, bone loss speeds up during the menopause transition as estrogen levels decline. That makes perimenopause and menopause a great time to take stock of your bone-health habits—especially strength training, nutrition, vitamin D, and other risk factors.

When Should you have a bone density test?

A DXA (or DEXA) scan is a quick, painless test that measures bone mineral density, usually at the hip and spine.

Current guidelines recommend screening all women starting at age 65. But you may need a DXA earlier if you are postmenopausal and have additional risk factors such as low body weight, smoking, excessive alcohol use, or a parent who fractured a hip. Certain medical conditions and medications—particularly long-term steroid use—can also warrant earlier testing. Your clinician can use a fracture-risk calculator such as FRAX to help decide when screening makes sense.

For men, routine screening recommendations are less clear, so the decision is generally based on age and individual risk factors.

What if your bone density is low?

First, don’t panic. “Osteopenia,” or mildly decreased bone density, does not automatically mean you need medication. We look at the whole picture: your DXA results, age, fracture history, family history, medications, and overall fracture risk.

When osteoporosis or significant fracture risk is present, medication can substantially lower the chance of a future fracture. Common treatments include bisphosphonates such as alendronate (Fosamax) or zoledronic acid (Reclast), as well as denosumab (Prolia). For people at very high fracture risk, medications such as teriparatide, abaloparatide, or romosozumab can actually stimulate new bone formation.

Lifestyle still matters even when medication is needed. Exercise, adequate calcium and vitamin D, maintaining muscle strength, and preventing falls are all part of osteoporosis treatment—not just extras.

The goal isn’t simply a better number on a bone density test. It’s keeping you strong, active, independent, and doing the things you love for as long as possible.

Wondering about your own bone health or whether it’s time for a DXA? It’s a great conversation to have at your next visit.