STRATEGIES FOR THE PREVENTION OF OSTEOPOROSIS IN SURGICALLY INDUCED MENOPAUSE: A SYSTEMATIC REVIEW OF CURRENT EVIDENCE
DOI:
https://doi.org/10.37547/Keywords:
surgical menopause, osteoporosis, bone mineral density, hormone replacement therapy, systematic review, fracture risk.Abstract
Surgically induced menopause, most commonly following bilateral oophorectomy, results in abrupt estrogen deficiency, leading to accelerated bone loss and a significantly increased risk of osteoporosis and fragility fractures. Compared to natural menopause, this condition is associated with more rapid deterioration of bone mineral density (BMD) and earlier onset of skeletal complications. Objective: to systematically evaluate current evidence on osteoporosis prevention in women with surgically induced menopause and to identify the most effective strategies for reducing bone loss and fracture risk. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, Scopus, and Web of Science were searched for studies published between 2000 and 2025. Eligible studies included randomized controlled trials, cohort studies, and meta-analyses assessing BMD changes, fracture risk, and preventive interventions such as hormone replacement therapy (HRT), calcium and vitamin D supplementation, and pharmacological treatments. Data were extracted and synthesized qualitatively due to heterogeneity among studies. Results: A total of 32 studies involving approximately 18,500 women were included. Surgically induced menopause was associated with rapid bone loss, with BMD declining by 2–7% annually in early post-surgical years. HRT demonstrated the most significant protective effect, reducing bone loss by 40–60% and lowering fracture risk by up to 50%. Calcium and vitamin D supplementation provided modest benefits, while bisphosphonates and other antiresorptive agents were effective in high-risk populations. Combined preventive strategies showed superior outcomes compared to monotherapy. Early initiation of treatment was consistently associated with improved bone health outcomes. Conclusion: Women with surgically induced menopause are at high risk for accelerated bone loss and osteoporosis. Early, combined, and individualized prevention strategies—particularly those including hormone replacement therapy—are essential to reduce fracture risk and improve long-term outcomes.
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