#BodyTalkWithCosmo: What really happens to your bones after 35—and how to keep them strong

Bone health might not be the most glamorous topic on your wellness radar, but it deserves a spot, especially once you hit your 30s. Most women reach peak bone mass by age 35, and from there, density begins to dip, quietly but steadily. The shift accelerates during and after menopause, thanks to hormonal changes, making early intervention more important than most realise.

This isn’t just about preventing fractures down the line—it’s about building a strong foundation for long-term health. The upside? With the right awareness and a few proactive steps, bone loss isn’t just manageable—it can be slowed and, in some cases, even reversed.

To help decode what’s really going on beneath the surface, Dr Lokesh Naik G, senior consultant, orthopaedics at Sir H N Reliance Foundation Hospital and Research Centre, Mumbai, shares a medical deep dive into bone density, what shifts after 35, and why now’s the time to start paying attention.

Understanding bone density: A silent decline

“Bone density is essentially about how much calcium and mineral is deposited in your bones. When the bone is heavy, it’s healthy. If it's light, it’s weak,” explains Dr Naik. At the cellular level, the body’s bones are in a constant state of renewal through a “coupling mechanism.” Dr Naik breaks it down, adding, “There is one cell that forms bone and another that removes it. When they’re in balance, your bones remain strong. We call this bone homeostasis.”

Why 35 is a pivotal age

“Age 35 is when your bone mineral density peaks. You’re active, eating well, and doing weight-bearing exercises, which boost bone strength. But after that, if your lifestyle becomes more sedentary, the decline starts,” says Dr Naik. Bone density is typically measured using a DEXA scan, which compares your mineral levels to those of an average healthy 35-year-old. A drop below certain thresholds (-1 to -2.5) signals osteopenia, and beyond -2.5, it’s diagnosed as osteoporosis.

Covid and the sedentary fallout

While age is a known factor, lifestyle disruptions like the Covid-19 pandemic had a surprisingly large impact. “Sitting too much led to bone loss. Activity promotes bone formation; inactivity does the opposite,” explains Dr Naik. He also highlights a lesser-known post-Covid effect. “The clotting mechanisms increased, and blood circulation to bones got compromised. That reduced calcium supply and further weakened bones.”

Menopause: When bone loss accelerates

The biggest bone health curveball for women is hormonal changes. “In perimenopause, the amount of mineral going into your bones remains the same, but the amount going out triples. It may seem like micro quantities, but over time, it causes real damage,” says Dr Naik. Unfortunately, many women only realise the issue once it's too late. “A 60-year-old woman with bone pain has likely lost her window to prevent damage. But a 45-year-old still has a fighting chance if we start treatment early,” he advises. He further warns, “You have to prepare for your future in the present. Don’t wait until menopause or until life ‘settles down’.”  

His prescription for better bones

Start walking and weight-bearing exercise: “Wolf’s Law says that when you put bones under strain, they get stronger. That’s how you stimulate bone formation.” 

Eat a calcium-rich diet—but support absorption: “Only 10 per cent of the calcium you consume is absorbed. Vitamin D increases that, and magnesium helps activate the Vitamin D. K27 also supports the process.”

Avoid bone enemies: “Try not to drink or smoke. Avoid cold drinks. They negatively affect bone health.”

Get tested early: “DEXA scans help detect early loss in areas prone to osteoporosis—the spine, hip, and wrist.”
Strong bones aren’t built overnight. But they can be protected with timely care, activity, and awareness, long before the first fracture.

All images: Pexels

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