1. Ignoring Hormonal Health: The First Big Mistake
Hormones are deeply connected to bone health, but many women don’t realize it until they're facing issues like perimenopause, menopause, or amenorrhea (absence of menstruation). Here's how it plays out:
Estrogen: This hormone slows down bone resorption (the process of bone breakdown). When estrogen drops—like during menopause or due to missing periods (amenorrhea)—your bones suffer. Long-term low estrogen levels, whether caused by stress, overtraining, or perimenopause, can kickstart bone loss years before menopause officially begins.
Progesterone: Often overlooked, progesterone helps stimulate new bone formation. If you're not ovulating regularly (which is the case for many women dealing with amenorrhea), your body isn't producing enough progesterone, meaning you’re missing out on this critical bone-building process.
Testosterone: While testosterone is generally associated with men, it plays a significant role in women’s bone health amongst other things. This hormone helps with maintaining bone mass, and a decline in testosterone—something that often happens due to stress, lack of sleep, or age—makes bones more vulnerable to breakdown.
The big problem? These hormonal shifts start happening WELL before menopause, and yet we don’t often pay attention until it’s too late. Bone loss and conditions such as osteopenia can start as early as your 20s. Their trajectory absolutely begin shifting in perimenopause which can begin as early is mid 30s to 40s, and by the time menopause hits, your bones are already in a weakened state.
2. Amenorrhea: Women’s Silent Bone Health Risk
If you’re a woman, who is not in late stage perimenopause, experiencing amenorrhea—whether it's due to stress, overexercising, or chronic dieting—you’re putting your bones at serious risk.
When a female has amenorrhea she is not ovulating, and without ovulation, there’s no progesterone. Over time, this lack of progesterone can result in less bone being built, while ongoing low estrogen levels accelerate bone breakdown.
For women in their 20s and 30s, this can create a dangerous foundation for future bone loss, setting the stage for osteoporosis down the line. Many women assume that if they’re young and otherwise healthy, they don’t need to worry about things like bone health. But it’s exactly during this time that you should be building as much bone density as possible.
Note: To be accurate, when I say "there's no progesterone," it’s not entirely precise. Women do produce some progesterone (a neurosteroid) in their adrenal glands, and in very small amounts in the brain and spinal cord. However, these small amounts produced in the adrenal glands, brain, and spinal cord are not sufficient to replace the significant levels of progesterone that are produced by the ovaries, especially during the luteal phase of the menstrual cycle.
3. Not Strength Training: Your Bones Need the Stress
Let’s talk about exercise. Specifically, the kind of exercise that stimulates bone growth.
While walking, yoga, and pilates are great, they simply aren’t enough when it comes to preventing bone and muscle loss (remember you may be lean but you can still have more fat than someone who appears more curvy). Bones respond to mechanical stress—meaning that weight-bearing exercises like lifting weights or engaging in impact sports (think running, jumping, or playing sports) are crucial for building and maintaining bone density.
Here's why it matters: When you lift weights, the stress placed on your muscles and bones forces your body to adapt by growing stronger. This process stimulates bone growth, increasing bone density and reducing your risk of fractures later in life. If strength training isn’t a regular part of your weekly routine, you’re missing out on one of the most powerful tools for protecting your bones.
I’d also like to emphasize how important athleticism, mobility, and strength are when it comes to your ability to adapt to your environment. Whether it’s catching yourself during a fall or navigating uneven ground, these physical attributes play a key role in your daily life.
One of the most overlooked skills is control of ones body (ie: body awareness) and thus balance—something that becomes even more critical as we age. Practicing balance in different positions and with varied load placements (whether it's holding a weight, shifting your body weight, or even carrying groceries) can go a long way in maintaining overall stability and preventing injuries.
Your health, your fitness, your strength training---all skills that translate into real-world situations, helping you move more confidently through everyday activities. Plus, incorporating balance work challenges your muscles and bones in different ways, which can contribute to better bone health over time. This is something we do with our clients as they progress in pregnancy too! Think of it as insurance for your body—giving yourself the ability to adapt, react, and stay strong, no matter what life throws your way.
Bottom line? While yoga and walking can help maintain flexibility and yes help cardiovascular health, they're not enough to preserve bone mass. If you’re not already strength training, it’s time to start. Your bones will thank you for it.
4. The Slow Creep of Bone Loss: It Starts Sooner Than You Think
Osteoporosis is often viewed as an issue that only impacts women post-menopause. But by the time you’re actually facing a diagnosis, the reality is that years (if not decades) of bone loss have already occurred.
For many women, bone loss starts in their late 20s or early 30s, especially if they’ve experienced lower hormone status, have gone through periods of intense stress ( not suggesting you can or should avoid stress---merely ensuring that we touch on that allostatic stress load and the systemic impacts), or have struggled with conditions like amenorrhea. The slow creep of bone loss continues silently for years. When menopause hits, the rate of bone loss accelerates rapidly due to the sharp drop in estrogen.
This is why it’s so important to think ahead. Maintaining your bone density should be a priority long before menopause becomes a concern. Addressing lifestyle factors and focusing on hormonal health in your 20s, 30s, and 40s can significantly impact your risk of osteoporosis later in life.
The takeaway? Working on your hormones (thyroid and insulin is also in the mix) and keeping an eye on your menstrual cycle isn't just about reproductive health; it's essential for your long-term bone health as well.
5. It’s Never Too Late to Protect Your Bones
If you're reading this and realizing you haven’t paid much attention to your bone health—don’t panic. It’s never too late to make a change, and every small step helps.
Here’s where to start:
Support Your Hormones: Keep track of your cycles and work with a healthcare provider to address any hormonal needs especially if you’re experiencing irregular periods or amenorrhea. Hormonal health and bone health go hand in hand.
Start Strength Training: If you’re not already lifting weights or doing impact sports, now is the time.
Nutritional Support: Make sure you’re eating enough for your body and activity level. This means not just total calories although they matter, this means macronutrients (carbs, fat and protein) as well as Micronutrients (vitamins and minerals). Getting enough vitamin D, boron, magnesium, sodium and other bone-supportive nutrients. Your bones need the right building blocks to stay strong.
Digestive Health: We have and will continue to hammer this in. If you have no idea about digestive health please check out our other blogs and posts!
Ready to get take charge of what all that you can control? Our coaches offer consulting services for both the individual eager to make changes or the professional who needs the experienced guidance .