How does menopause affect bone density?

• A. Bone density increases due to hormonal balance.
• B. No change in bone density.
• C. Accelerated bone loss occurs due to estrogen deficiency.
• D. Only affects bone density after age 70.

Answer: (C)

Menopause triggers a drop in estrogen, which shifts bone remodeling toward resorption. Estrogen normally inhibits osteoclasts, helping maintain bone density. When estrogen falls, osteoclast activity increases more than osteoblast activity, causing net bone loss and a drop in bone mineral density. This accelerated loss begins soon after menopause, especially in the first several years, and raises the risk of osteoporosis and fractures, particularly in trabecular-rich sites like the spine and hip. It is not limited to those over 70, and the pattern is a menopause-associated acceleration of bone loss rather than no change or an increase.