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how does low estrogen affect bone density?

 Estrogen plays an important role in maintaining bone structure and density. When estrogen levels decrease, such as after menopause, the risk of osteoporosis and bone loss rises

8th
.Low estrogen levels can lead to porous, weakened bones and osteoporosis
6
.  The majority of postmenopausal females with osteoporosis have bone loss related to estrogen deficiency. The rapid bone loss results from an increase in bone turnover with an imbalance between bone resorption and bone formation
4
.At a cellular level, several mechanisms contribute to the bone loss related to estrogen deficiency. Estrogen affects bone cells, including osteocytes, osteoblasts, and osteoclasts. The lack of estrogen ages the expression of estrogen target genes, increasing the secretion of IL-1, IL-6, and tumor necrosis factor (TNF). Studies have also shown that estrogen deficiency directly affects cell differentiation and apoptosis. The net effects of estrogen deficiency are increased bone turnover and enhanced bone resorption, which result in osteoporosis
6
4
.In young women with estrogen deficiency, such as those with primary ovarian insufficiency (POI), bone density is lower compared to regularly menstruating women
2
.Preventing bone loss is an important concern for women in the menopause journey and during post-menopausal stages. 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
7
.There are various ways to prevent bone loss, including eating a diet rich in calcium and doing weight-bearing exercise regularly. Medical treatments for osteoporosis are available, including hormone replacement therapy (HRT). HRT is medication that contains female hormones, and you take the medication to replace the estrogen that your body stops making during menopause. HRT is most often used to treat common menopausal symptoms, including hot flashes and vaginal discomfort. HRT has also been proven to prevent bone loss and reduce fracture in postmenopausal women
3
.

Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381441/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2708959/
[3] https://www.sciencedirect.com/science/article/pii/B9780128130735000320
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836058/
[5] https://www.intechopen.com/chapters/48016
[6] https://www.medicalnewstoday.com/articles/estrogen-and-osteoporosis
[7] https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
[8] https://www.healthline.com/health/osteoporosis/estrogen-and-osteoporosis
[9] https://www.sciencedirect.com/topics/medicine-and-dentistry/estrogen-deficiency
[10] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-osteoporosis
[11] https://academic.oup.com/jcem/article/83/7/2239/2865147
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