Which is more osteoporosis-inducing, menopause or oophorectomy?

The present study was designed to investigate in a comparative manner whether menopause or oophorectomy (OPX) would be a more osteoporosis-inducing factor with regard to sex steroids, bone metabolism and bone mineral density (BMD), including postmenopausal subjects, OPX subjects and age- and body-size-matched premenopausal controls. Serum levels of estradiol (E2), testosterone (TS) and dehydroepiandrosterone (DHEA) were found to decrease in both the postmenopausal and OPX subjects without any significant difference between them, while serum levels of estrone (E1) and androstenedione (delta 4), which have been reported to be related to bone metabolism, were significantly lower in the OPX subjects than in the postmenopausal subjects. According to the indices representing bone formation and bone resorption, as well as the changes in serum levels of Ca-regulating hormones, bone metabolic balance seemed to be slightly more negative in the former than in the latter. However, there was no difference between these two groups of subjects with regard to BMD in lumbar vertebral spongy portion which sensitively reflects the changes in total lumbar BMD and bone metabolism and in which compressive fracture is apt to occur. This fact suggests that these two groups of subjects may be managed in the same way in clinical practice. In other terms, the menopause, a natural event in women, influences BMD as much as OPX, which is the greatest risk factor in osteoporosis, does.