Critical implications of female bone metabolism in orthopedics: state of the ART
Abstract
Female bone metabolism is a dynamic and tightly regulated process that plays a pivotal role in musculoskeletal health and orthopedic outcomes across the lifespan. Bone remodeling depends on the balance between osteoblastic bone formation and osteoclastic bone resorption and is strongly influenced by hormonal status, nutrition, genetics, physical activity, and systemic disease. In women, this balance is profoundly affected by reproductive and aging-related transitions, including adolescence, pregnancy and lactation, perimenopause, menopause, and postmenopause. Maximal peak bone mass is typically achieved by late adolescence or early adulthood and is a major determinant of future fracture risk. Inadequate nutrition, low energy availability, and insufficient weight-bearing activity during this critical period can compromise bone strength. In female athletes, Relative Energy Deficiency in Sport (REDs), formerly described as the Female Athlete Triad, is characterized by low energy availability (LEA), reproductive hormone suppression, and impaired bone health, substantially increasing the risk of bone stress injuries (BSI) and potentially leading to long-term deficits in bone mineral density (BMD). Hormones, particularly estrogen and progesterone, are central regulators of female bone metabolism. Estrogen deficiency-most notably during the menopausal transition-leads to accelerated bone loss, deterioration of bone microarchitecture, and a marked increase in osteoporotic fracture…
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.