The The Impact of Menopause on Bone Mineral Density and the Development of Osteoporosis

Abstract

Bones are structures with a rich physiology and active metabolism, performing essential functions such as body support, regulation, and storage of calcium and phosphorus in the form of hydroxyapatite crystals, as well as the synthesis of the formed elements of blood tissue. They are composed of an organic matrix, primarily made of type I collagen and proteoglycans, and an inorganic matrix, composed of hydroxyapatite crystals. Maintaining the balance between the production and resorption of bone matrix, mediated by osteoblasts, osteocytes, and osteoclasts, is crucial for tissue health and ion regulation in the blood. However, dysregulations in this process can lead to increased bone resorption and reduced matrix formation, compromising the structural function of bones. This situation is particularly concerning for postmenopausal women due to the reduction of sex hormones, such as estrogen, which plays a protective role against osteoporosis. The aim of this study was to review the main pathophysiological aspects of osteoporosis related to estrogen deficiency and its implications for bone metabolism, with an emphasis on metabolic consequences and preventive or therapeutic approaches for postmenopausal women. This is a literature review based on articles selected from the PubMed and SciElo databases. The descriptors "Osteoporosis," "Postmenopausal Osteoporosis," "Women," "Hormones," and "Sex Hormones," according to DeCS/MeSH, were used. Inclusion criteria considered articles relevant to the theme, available in English or Portuguese, with no time restriction on publication. Initially, titles and abstracts were analyzed for thematic screening, followed by full-text reading of the selected studies. Finally, articles addressing postmenopausal osteoporosis and the role of sex hormones in bone metabolism were included. Osteoporosis, if untreated, can lead to serious consequences, significantly impacting patients' quality of life and increasing morbidity and mortality due to fractures, particularly of the femoral neck and head.