Osteoporosis is highly prevalent in postmenopausal women and has long been associated with an increased risk of bone fractures. New research suggests that women’s overall risk of death can increase by as much as 47%, especially within a certain range of bone mineral density (0.46 to 0.71 g/cm2 of total bone mineral density in the femur). The research results will be published online today. menopauseJournal of the Menopause Society.
As the overall population ages, the incidence of osteoporosis will also increase. The global prevalence of osteoporosis in 2022 was 19.7%, and the prevalence in women was significantly higher than in men (23.1%). According to one study, by 2030, the number of people worldwide affected by osteoporosis will reach 263 million, of whom 154 million will be women. Previous studies have reported that postmenopausal women have a significantly higher mortality rate within 1 year after a hip or vertebral fracture.
Declining estrogen levels during the menopausal transition are associated with many physiological changes across multiple systems, including bone metabolism, cardiovascular function, muscle mass, and fat distribution. When it comes to bone health, decreased estrogen levels promote bone resorption, inhibit bone formation, and rapidly reduce bone density (especially in the thighs), resulting in an increased risk of osteoporosis and fractures.
Most previous studies have focused on the association between decreased bone density and adverse outcomes such as falls and fractures. However, there is a lack of systematic studies examining whether increased bone density in postmenopausal women can reduce mortality risk. The new study, which included approximately 3,000 postmenopausal women, used dual-energy X-ray absorptiometry to assess bone mineral density at four sites on the thigh.
The analysis revealed that the risk of death was significantly increased when the bone density of the femur reached the osteoporosis threshold or when an osteoporotic fracture was present. After fully adjusting, osteoporosis was associated with a 47% increased risk of death. A strong inverse association between increased bone mineral density and mortality risk was observed within certain ranges, suggesting that bone mineral density serves as a prognostic biomarker of general health status.
The research results are published in the paper “Femoral Bone Density and Mortality Risk in Postmenopausal Women: A Cohort Study of the National Health and Nutrition Examination Survey.”
Osteoporosis has a significant impact on women’s lives, from loss of height, loss of balance and mobility to disfigurement, pain and even premature death, yet it often remains a potential threat after menopause. Early screening and preventative measures, such as a calcium-rich diet (preferably from food sources), regular weight-bearing exercise, and, if necessary, hormone therapy, can significantly improve bone health and reduce the risk of not only bone fractures but also cardiovascular disease, certain cancers, and dementia. It’s time to bring this conversation to the forefront. ”
Dr. Monica Christmas, Associate Medical Director, Menopause Medicine Society
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Reference magazines:
Chan, Z. others. (2026). Femoral bone density and mortality risk in postmenopausal women: a cohort study of the National Health and Nutrition Examination Survey. menopause. DOI: 10.1097/GME.0000000000000002787. https://menopause.org/wp-content/uploads/press-release/MENO-D-25-00398.pdf
