Women are more at risk of developing osteoporosis than men because the hormone changes that occur atmenopause directly affect bone density. The female hormone estrogen is essential for healthy bones. After themenopause, estrogen levels fall, which can lead to a rapid decrease in bone density.Postmenopausal osteoporosis, resulting from estrogen deficiency, is the most common type of osteoporosis.Estrogen deficiency results in an increase in bone turnover owing to effects on all types of bone cells. The imbalance in bone formation and resorption affects trabecular bone and cortical bone. Osteoporosis is diagnosed usingbone density measurements of the lumbar spine and proximal femur. Preventive strategies to improve bone healthinclude diet, exercise and abstaining from smoking. Fractures may be prevented by reducing the risk of falls inhigh-risk populations. Several drugs are licensed to reduce fracture risk by slowing bone resorption (such as bisphosphonates and denosumab) or by stimulating bone formation (such as teriparatide).The goals for treating osteoporosis are to slow or stop bone loss and to prevent fractures.
