Dr- Huda Shihab jari ,

From a biological and medical perspective, what you state is of course 100% factually accurate; however, it is possible for the reduction in bone mass to be offset when calcium and either vitamin D or magnesium vitamin supplements are ingested either through consuming nutritious foods containing them or taking vitamin supplements. Thus, it may be well advised for women to continue to drink milk, which is a natural source of calcium and vitamin D, and other natural sources, before, during, and after their child-bearing years. Even grandmothers should enjoy eating yogurt, cheeses, and similar foods. Grandmothers might like to join their grandchildren whenever ice cream is served!

The lack of estrogen, a natural consequence of menopause, is directly related to a decrease in bone density.

https://www.everydayhealth.com/menopause/osteoporosis-and-menopause.aspx

Yes the concept of 'Peak Bone mass' which you described holds right whether male or female. There might be many underlying pathogenesis not fully known to us regarding postmenopausal osteoporosis...

More and more newer research showing myriad ways of bone homeostasis...

Gut Flora can also impact bone health and may be affected by hormones...

The term 'osteomicribiology' may be big discipline in future...

In general, bone loss of density and hardness is accelerated after menopause, due to the decrease in estrogen levels in women associated with menopause. Besides, over time, the risk of developing osteoporosis increases for older women because the loss of bone density is higher than it can compensate.

Also beside calcium and vit D with magnesium supplementation ... Can adding estrogen supplementation with safe dose?

When you hit menopause, your oestrogen levels begin to decline.

Hello Dr- Huda Shihab jari ,

Alongwith hormonal and environmental factors, immunological parameters do plays a very crucial role in regulating bone health under physiological and osteoporotic conditions. Multiple studies highlighted that in post-menopausal conditions various inflammatory immune cells viz. M1 macrophages, Th17 etc. gets enhanced and this lead to higher production of inflammatory cytokines such as IL-17, TNF-alpha, IL-1 beta and all these cytokines known to upregulate bone deterioration by promoting the differentiation of bone resorbing cells viz. Osteoclasts. This bone loss is further augmented by the decreased population of anti-inflammatory immune cells such as Tregs, M2 macrophages and this further leads to reduction of anti-inflammatory cytokines such as IL-10 that are already known to inhibit bone loss by hampering the differentiation of osteoclasts precursors into mature osteoclasts. Thus, these imbalance between various inflammatory and anti-inflammatory immune cells leads to enhancement of bone loss.

The effect of estrogens on bone metabolism is given by a decrease in bone turnover of cytosine levels and an increase in axial bone mineral density. The influence of sex steroids on bone in men and women is recognized. In men, however, the relative contribution of androgens compared to estrogens in the regulation of bone metabolism remains uncertain. Studies in male rodents show that both estradiol (E2), through the activation of the estrogen-α receptors, and testosterone (T), through the activation of the androgen receptor, regulate bone mass. E2 is directly associated with bone mineral density (BMD) and its low serum concentrations are associated with higher rates of bone loss and fractures; its threshold determines the risk of fracture in elderly men. The effect of E2 on fracture risk is partly mediated by its action on BMD, while the more moderate effect of T on fracture risk is mediated by its effects on muscle strength and risk of falls. Racial and genetic variations in aromatase in serum E2 levels influence men. In conclusion, there is compelling evidence that androgens and estrogens are important regulators of bone health in men. Consequently, E2 should not be limited to being considered as the "female hormone", but as a sex steroid that is necessary for the maintenance of bone health in men.

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There is a direct relationship between the lack of estrogen during perimenopause and menopause and the development of osteoporosis. Early menopause (before age 45) and any prolonged periods in which hormone levels are low and menstrual periods are absent or infrequent can cause loss of bone mass.

https://www.endocrineweb.com/conditions/osteoporosis/osteoporosis-osteoporosis-women

Any loss of estrogens causes osteoporosis, it has been seen in highly competitive amenorrheic athletes

Postmenopausal osteoporosis may be the result of both reduced peak bone mass and the accelerated bone loss due to aging. Oestrogen has anabolic effects on bone and also on cartilage. Following menopause, there is an acceleration of bone loss due to Oestrogen insufficiency which results in imbalance in bone remodelling cycle where bone loss exceeds bone formation.

The risk and complications of postmenopausal osteoporosis can be reduced to a great extent by maintaining active lifestyle via exercising regular moderate intensity physical activities such as brisk walking or jogging, sufficient intake of calcium and vitamin D supplements, and importantly avoiding cigarette smoking.

د.بيداء عبدالسلام مهدي..Thank you so much for your kind agreement. Best regards

Estrogen is the key regulator of bone metabolism in both men and women. Menopause and the accompanying loss of ovarian estrogens are associated with declines in bone mineral density (BMD):

مهدي added an answer to this ResearchGate discussion thread question 7 hours ago, as follows:

انا اتفق مع اجابة الدكتور سلمان عجلان

Translation into English, as follows: "i agree with dr. Salman Ajlan's answer."*

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*Source: Internet Artificially Intelligent Translator

Hi Dr- Huda Shihab jari . Menopause significantly speeds bone loss and increases the risk for osteoporosis. Research indicates that up to 20% of bone loss can happen during these stages and approximately 1 in 10 women over the age of 60 are affected by osteoporosis worldwide. See the link: https://www.hormone.org/diseases-and-conditions/menopause/post-menopause-and-osteoporosis

Also, Oestrogen levels drop around the time of menopause, which occurs on average at the age of 50 years, resulting in increased bone loss. If your peak bone mass before menopause is less than ideal, any bone loss that occurs around menopause may result in osteoporosis. See the link:https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-osteoporosis

In addition to, Estrogen, a hormone in women that protects bones, decreases sharply when women reach menopause, which can cause bone loss. This is why the chance of developing osteoporosis increases as women reach menopause. See the link: https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/

Dear Dr Nancy Ann Watanabe. Many thanks for your kind agreement. Best regards

The absence of oestrogen, which is a normal result of menopause, is linked to a reduction in bone density. The longer a woman's oestrogen levels are low, the poorer her bone density will likely be.

Oestrogen level.....reduce deposition Ca++ in bon .