Building Strong Bones from Your 30s: An Investment in Your Future Health

Peak bone mass is typically reached in our late 20s to early 30s. After this point, bone resorption gradually begins to exceed bone formation. While this process is slow at first, it accelerates during perimenopause and menopause due to declining oestrogen levels, making early preparation essential rather than optional.

Why starting early matters

Research consistently shows that higher peak bone mass and healthier bones entering midlife significantly reduce fracture risk in later years (1,2). Women with a family history of osteoporosis are at an even higher risk, as genetics play a substantial role in bone density and fracture susceptibility (3). This makes proactive strategies in the 30s and 40s one of the most effective forms of prevention.

The role of exercise

Mechanical loading is one of the strongest drivers of bone strength. Weight-bearing and resistance exercises stimulate bone-forming cells, helping maintain or even improve bone density (4). Activities such as strength training, impact-based exercise (where appropriate), and progressive loading are particularly beneficial. Importantly, walking alone — while excellent for cardiovascular health — is often not enough to adequately stimulate bone.

A pelvic health physiotherapist can guide safe, individualised exercise programming, especially for women managing pelvic floor symptoms, joint pain, or postnatal recovery.

Nutrition and lifestyle foundations

Adequate calcium, vitamin D, protein, and overall energy intake are essential for bone health. Diets that are overly restrictive or chronically low in energy can impair bone turnover and increase fracture risk (5). Lifestyle factors such as smoking, excessive alcohol intake, and prolonged sedentary behaviour are also associated with poorer bone outcomes.

Bone health after pregnancy and lactation

Pregnancy and breastfeeding place unique demands on the maternal skeleton. During lactation, bone density can temporarily decrease as calcium is mobilised to support milk production (6). While much of this bone loss is typically recovered after weaning, not all women fully regain pre-pregnancy bone density — particularly with closely spaced pregnancies, prolonged breastfeeding, or inadequate nutrition and loading (7).

This makes the post-lactation period a key opportunity to reintroduce progressive resistance training, ensure nutritional adequacy, and address any ongoing musculoskeletal or pelvic health concerns.

Preparing for the menopausal transition

By investing in bone health earlier, women enter perimenopause with greater “bone reserves,” reducing the severity of menopausal bone loss and lowering long-term fracture risk (2). Early screening, especially for those with family history, menstrual irregularities, eating disorders, or prolonged periods of low body weight, may also be appropriate.

The bottom line

Strong bones are built through consistent, intentional habits over time — not quick fixes later in life. Starting in your 30s gives you the best chance of protecting independence, mobility, and quality of life well into older age. Seeking guidance from a pelvic health or women’s health physiotherapist can ensure your approach is safe, targeted, and effective across all life stages.

References (last 10 years)

1. Hernandez CJ, et al. Bone. 2017;95:64–70.
2. Eastell R, et al. Lancet. 2016;387(10020):1276–1287.
3. Ralston SH, Uitterlinden AG. Lancet. 2010;376(9741):972–985.
4. Daly RM, et al. Sports Medicine. 2019;49(6):857–872.
5. Weaver CM, et al. Osteoporosis International. 2016;27(12):3677–3688.
6. Kovacs CS. Endocrine Reviews. 2016;37(2):187–225.
7. Bjørnerem Å, et al. Journal of Bone and Mineral Research. 2017;32(8):1550–1559.