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What Happens to Astronauts’ Bones After 90 Days in Space? Scientists Have an Answer

Space exploration is entering a new era. Future astronauts are expected to spend months or even longer away from Earth as space agencies prepare for missions to the Moon and eventually Mars. But while rockets, habitats and life-support systems continue to improve, scientists are paying increasing attention to another challenge: what happens to the human skeleton during long periods in space?

A new study published in Mayo Clinic Proceedings has found that astronauts who completed spaceflights lasting more than 90 days experienced higher rates of hip fractures than astronauts after shorter missions and people who had never traveled to space.

The finding highlights an important concern for the future of human space exploration. Astronauts are generally selected for excellent physical health, but spending extended periods in microgravity can cause changes inside the body that may not be obvious when they return to Earth.

Why Does Spaceflight Affect Bones?

On Earth, our bones constantly respond to gravity and physical activity. Every time we stand, walk, run or lift something, our skeleton experiences mechanical forces.

In space, the situation is very different.

Astronauts live in a microgravity environment where their bodies no longer have to support their normal weight. As a result, bones experience much less mechanical loading. Over time, this can cause bone and mineral loss.

This process is similar to what happens when bones are not used normally for extended periods. The skeleton gradually adapts to the reduced demand.

Muscle loss is also common during spaceflight, and the combination of weaker muscles and changes in bone structure can create additional challenges when astronauts return to Earth's gravity.

The most concerning part is that astronauts may not actually feel their bones becoming weaker.

The Hidden Problem After Returning to Earth

According to Jean D. Sibonga, Ph.D., the lead investigator from NASA's Johnson Space Center, people generally do not feel the effects of bone loss.

That creates an important problem for astronauts.

After returning from a long mission, an astronaut may feel stable and believe that their body has recovered. They may then return to exercise, training or physically demanding activities.

However, their bones may still have structural changes caused by prolonged exposure to microgravity.

The new study suggests that these changes may have consequences years later, particularly when it comes to hip fractures.

Longer Space Missions Showed a Different Pattern

Researchers examined fracture information from U.S.-based astronauts collected during annual clinical examinations. Instead of looking only at the total number of fractures, they used Bayesian probabilistic modeling to analyze the relatively small astronaut population.

This approach was important because astronauts are a very unusual study group. There are relatively few astronauts, and long-duration space missions are still uncommon.

The researchers did not find that astronauts experienced a higher rate of all types of fractures.

However, one result stood out.

Astronauts who had spent more than 90 days in space showed a higher rate of hip fractures.

The fractures also occurred at younger ages than researchers would normally expect in people who had not experienced spaceflight.

The rate was also higher compared with astronauts before they completed a long-duration mission and with astronauts who had never traveled to space.

This provides an important real-world indication that bone changes caused by spaceflight may eventually translate into actual fractures.

Why Hip Fractures Matter

Hip fractures are especially important because they can have serious effects on mobility and long-term health.

For astronauts, the concern is even more significant because future exploration missions will require people to perform demanding physical tasks after spending months in space.

NASA is planning missions lasting more than six months, including activities in low Earth orbit and the Artemis program's return to the Moon. The agency is also working toward sustainable lunar surface operations that could eventually support missions to Mars.

A Mars mission would create an even greater challenge.

Astronauts could spend many months traveling through space before reaching the planet. After that journey, they would need to work in a different gravitational environment while carrying equipment and performing physically demanding tasks.

If their skeletal system has not fully recovered, even normal activities could potentially place additional stress on vulnerable bones.

Current Bone Monitoring May Not Tell the Whole Story

NASA already monitors astronauts' bone health using dual-energy X-ray absorptiometry, or DXA, which measures bone mineral density.

But researchers say that bone mineral density alone may not provide a complete picture of fracture risk.

Two bones can have similar measurements of mineral density but differ in their internal structure and strength.

That is why NASA has recently started ordering quantitative computed tomography (QCT) scans before and after spaceflight.

QCT can provide more detailed information about the skeleton, including different regions of the bone and aspects of its internal structure.

This could help scientists determine whether an astronaut's skeleton has actually returned to its preflight condition.

That information could be particularly useful when deciding when an astronaut can safely return to intense physical activity.

Preventing Bone Damage Before It Happens

The researchers believe prevention should begin before astronauts leave Earth.

Maintaining strong bones before launch could give astronauts a better starting point for dealing with the effects of microgravity.

Scientists are also interested in understanding which countermeasures work best during and after spaceflight.

Possible approaches include:

  • Specialized exercise programs

  • Dietary adjustments

  • Medications that influence bone metabolism

  • More detailed bone monitoring

  • Longer recovery periods after missions

Exercise is already an important part of astronaut training and spaceflight. But future research may help determine whether exercise programs need to be adjusted specifically to protect different regions of the skeleton.

Better imaging could also help doctors identify astronauts who remain at higher risk after returning to Earth.

A Bigger Challenge for Moon and Mars Missions

The study arrives at an important moment for human space exploration.

Short space missions are one thing. Living away from Earth for six months, a year or longer is very different.

As missions become longer, astronauts will spend more time exposed to microgravity and its effects on the body. That means skeletal health could become an increasingly important part of mission planning.

The issue is not simply whether astronauts can survive a long journey.

They must also be able to arrive healthy, perform their tasks safely and recover properly after returning to Earth.

For Mars exploration in particular, protecting bones could become as important as managing radiation exposure, isolation and life-support systems.

The Future of Astronaut Health

The new findings do not mean that long-duration spaceflight inevitably causes hip fractures. The number of astronauts available for research remains relatively small, and scientists acknowledge that this limits the precision of the data.

However, the observed association provides another reason to investigate the long-term effects of space travel on the human skeleton.

As Moshe Gertzulin, M.D., a co-author of the accompanying editorial, noted, the occurrence of hip fractures at younger-than-expected ages after long-duration spaceflight provides clinical evidence that spaceflight-related bone loss can have real consequences.

The next generation of space exploration will require more than powerful rockets and advanced spacecraft. Scientists must also learn how to protect the human body from an environment it never evolved to experience.

The biggest spaceflight health risks may not always be visible. For astronauts preparing to spend months on the Moon or travel to Mars, strong bones could be just as important as a strong spacecraft.

Reference: Increased Rates of Hip Fractures Associated With Longer Spaceflight Durations, Mayo Clinic Proceedings (2026), DOI: 10.1016/j.mayocp.2026.06.025.

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