Management of postmenopausal osteoporosis.
1Department of Medicine, University of Auckland, Auckland 1142, New Zealand.
Endocrine Reviews
|February 26, 2026
Summary
Postmenopausal women face significant bone loss and fracture risk. This review covers osteoporosis, risk assessment, lifestyle, and effective pharmaceutical treatments like bisphosphonates and newer agents for bone health.
Area of Science:
- Gerontology
- Endocrinology
- Orthopedics
Background:
- Postmenopausal women experience progressive bone mass reduction, elevating fracture risk.
- Osteoporosis is a critical concern, necessitating accurate fracture risk assessment for effective management.
- Falls are a primary cause of fractures in aging populations.
Purpose of the Study:
- To review postmenopausal bone loss, osteoporosis definition, and fracture risk estimation.
- To discuss lifestyle modifications and pharmaceutical interventions for osteoporosis.
- To explore current and emerging treatments for enhancing bone mass and preventing fractures.
Main Methods:
- Literature review of postmenopausal bone loss, osteoporosis, and fracture risk.
- Analysis of lifestyle factors impacting bone health.
- Evaluation of pharmaceutical agents targeting bone resorption and formation.
Main Results:
- Lifestyle measures (diet, exercise, smoking cessation, moderate alcohol) are crucial.
- Vitamin D deficiency exacerbates bone loss; falls prevention is vital.
- Bisphosphonates (oral, zoledronate), denosumab, PTH1 receptor agonists, and romosozumab offer varied fracture prevention benefits.
Conclusions:
- Effective management of postmenopausal bone loss involves lifestyle changes and targeted pharmacotherapy.
- Newer agents like romosozumab show broad anti-fracture efficacy, while anabolics require transition to anti-resorptives.
- Further research is needed to optimize sequential treatment strategies for maximal fracture reduction.
Related Concept Videos
01:40Bone Remodeling
40.7K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
40.7K
01:28Menopause
5.1K
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
5.1K
01:29Bone Disorders
5.7K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
5.7K
01:31Osteoclasts in Bone Remodeling
4.4K
Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
4.4K
01:25Role of Vitamins in Maintaining Bone Health
5.8K
The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
5.8K
01:26Atherosclerosis III: Management
516
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
516