| At the time of the menopause in women, there is an | | | | predispose to fractures. |
| imbalance that results in a relative excess of | | | | The bone loss with aging is accentuated in women |
| resorption. This only shows that there are more | | | | because of menopause. This menopause has a major |
| osteoclast activity over osteoblast activity. In joined | | | | consequence which is a fracture. Fractures typically |
| with this is the acceleration in the frequency of the | | | | occur at sites in the skeleton where bone is turning |
| remodelling cycle. This is referred to as activation | | | | over fastest. These sites may include the regions |
| frequency. This will result in a net loss of bone tissue in | | | | which predominantly contain what we call cancellous |
| women over the ten years following the menopause. | | | | or trabecular bone. Examples of these are the |
| After that time, there is a slower rate of bone loss. | | | | vertebral body, proximal femur, hip, distal forearm and |
| This is applicable not only for women but for men too. | | | | wrist. And the fractures at the vertebral body, the hip |
| This is due to an impairment of osteoblast | | | | and the wrist account for almost fifty to sixty percent |
| responsiveness to mechanical stimuli. This is also the | | | | of all the fractures that arise in post menopausal |
| result of secondary hyperparathyroidism wherein a | | | | women. |
| relative blunting of the Vitamin D axis leads to a switch | | | | These fractures are associated with considerable |
| of the parathyroid hormone production. So a deficiency | | | | morbidity. They may also entail an excess mortality for |
| in estrogen, secondary hyperparathyroidism and | | | | fracture in hips and vertebra. It is important to identify |
| osteoblast reduction will more likely happen. If this | | | | these fractures as a marker of future risk of |
| happens, it will entail an excess of bone resorption. This | | | | osteoporosis and to assess and treat appropriately |
| will lead to an excess risk of bone loss and may | | | | patients who have been identified. |