About half of women over 50 will break a bone because of osteoporosis, a condition that weakens bones, making them more likely to fracture. The good news is that osteoporosis is preventable and treatable, and the earlier you start protecting your bones, the better.

Dr. Kristen DeCarlo, an endocrinologist at UI Health in Chicago, shared practical tips with ThisIsMenopause to help women support bone health before, during, and after menopause.

Here are seven tips to help you protect your bones as you age.

A bone density scan — also called a bone density test, DXA scan, or DEXA scan — is one of the best ways to detect osteoporosis. This test uses low levels of X-rays to measure calcium and other minerals in the bones.

The U.S. Preventive Services Task Force recommends that all women 65 and older get a routine bone density screening, Dr. DeCarlo said. Postmenopausal women under 65 should also be screened if they have osteoporosis risk factors, such as low body weight, a family history of hip fractures, or excessive alcohol use.

Medicare and most private insurance plans cover bone density scans that are medically necessary. Without insurance, the average out-of-pocket cost is at least $300.

Menopause hormone therapy, also known as hormone replacement therapy (HRT), can help relieve hot flashes and other menopause symptoms. HRT may also help lower the risk of osteoporosis and bone fractures.

“In the perimenopausal and postmenopausal time, we know that if you replace both estrogen and progesterone, it reduces hip fractures by around 30 percent,” Dr. DeCarlo said.

Hormone therapy isn’t right for everyone, however. Potential side effects include a higher risk of blood clots, stroke, certain types of breast cancer, and other health issues, particularly with long-term use. It’s important to discuss the risks and benefits with a healthcare professional.

Dr. DeCarlo noted that the bone-protective benefits of menopause hormone therapy last only while you’re taking it. If you stop, those benefits gradually go away. “But it’s a reasonable option for osteoporosis prevention in early menopause,” she added.

Regular physical activity, especially weight-bearing exercise and strength training, helps support healthy bones. After checking with your doctor to make sure it’s safe — especially if you’ve had a bone fracture — aim to be active most days of the week.

“A combination of aerobic exercise and resistance training is the best way to improve bone density in the pre- and postmenopausal period,” Dr. DeCarlo said. “You’ll see the greatest improvement when you have both.”

Weight-bearing aerobic exercises include brisk walking, climbing stairs, dancing, and playing pickleball. Resistance training includes exercises that build muscle strength, such as lifting weights, using resistance bands, or doing body-weight exercises like squats and push-ups.

“Walking is good, but it may not be sufficient,” Dr. DeCarlo said. “You need a little bit of resistance to help improve bone density.” Adding stair climbing, light jogging, or small jumps to your walking routine can boost the benefits. Wearing a weighted vest may also help, though research is limited.

The American College of Sports Medicine recommends weight-bearing endurance exercise three to five times a week and resistance training two or three times a week for bone health.

Getting enough calcium is important for bone health. Eating a balanced, nutrient-rich diet can also help support bone and muscle health during menopause.

“In perimenopause and postmenopause, the best way to get calcium is through diet,” Dr. DeCarlo said. Good sources of calcium include dairy products, fortified foods, whole grains, and leafy green vegetables. Sardines and canned salmon are also good sources.

“There are a lot of vegetable and plant-based sources of calcium,” Dr. DeCarlo added. “It doesn’t have to be milk. Eating whole foods that have calcium in them is good for the bones.”

The International Osteoporosis Foundation offers a free calcium calculator to estimate how much calcium you get from your diet. Calcium needs vary by age and gender, but most adult women need about 1,000 to 1,200 milligrams a day. Dr. DeCarlo recommends spreading calcium intake across meals to help your body absorb this nutrient more efficiently.

If you’re not getting enough calcium through your diet, your healthcare provider may recommend a calcium supplement. During perimenopause, declining estrogen levels make it harder for the body to absorb calcium. After menopause, more calcium is lost through urine.

Vitamin D is another important nutrient for bone health. Depending on where you live, you might not get enough sunlight for your body to make what it needs. “Most of us who live in the Northern Hemisphere don’t get enough vitamin D,” Dr. DeCarlo said. “It typically needs to be supplemented.”

Many supplements are available over the counter, but it’s important to talk with your doctor before starting something new. If they recommend calcium and vitamin D supplements, ask how much to take and when.

Smoking and drinking raise the risk of osteoporosis and may trigger hot flashes and other menopause symptoms. Cutting back or quitting can help protect your bones as well as your overall health and quality of life. “Avoiding tobacco and excess alcohol is important,” said Dr. DeCarlo, who recommends that women have no more than “one to two drinks in an evening.”

Making lifestyle changes isn’t always easy, but it’s worth the effort. If you need help, your doctor can connect you with support groups and other resources.

Talking with your doctor about bone health is an important step in preventing osteoporosis. This includes reviewing medications, family history, and any personal risk factors.

“Talk with your doctor about nonmodifiable risk factors,” Dr. DeCarlo said. “Did Mom or Dad break a hip or spine? Does osteoporosis run in the family? It’s good to have that prevention conversation because in the world of medicine, we should be thinking about how to prevent things.”

If you already have osteoporosis or develop it later, help is available. Your doctor can recommend treatment options and strategies to reduce your risk of fractures.