The biology, medical management, and podiatric implications of menopause

Approximately 36 million women in the United States are in the postmenopausal phase of life, creating unique challenges for the provision of compassionate, comprehensive podiatric medical treatment. Long-term estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of ischemic heart disease, osteoporosis, and concomitant podiatric complications. This article discusses the physiologic basis of menopause, hormone replacement therapy and its effects on osteoporosis, and other podiatric implications of menopause. Podiatric physicians caring for larger numbers of peri- and postmenopausal women must formulate a comprehensive management plan for treating fractures that arise from a combination of estrogen-deprivation osteoporosis and abnormal foot biomechanics.