Postmenopausal Osteoporosis: A Mini Review

Abstract

Postmenopausal osteoporosis is an oestrogen deficiency-induced, systemic skeletal disease that affects the quality of life of patients once severe complications develop. The imbalance in osteoclastogenesis and osteoblastogenesis is the crucial pathological basis of osteoporosis and it is affected by classical pathways, epigenetic regulation, post-transcriptional regulation, oxidative stress-mediated signalling, and gut microbiotas. New methods to manage postmenopausal osteoporosis are essential and urgent. Dual-energy X-ray absorptiometry derived bone mineral density is acknowledged as the gold standard for osteoporosis diagnosis, and FRAX®, along with other clinical risk factors, has been used for osteoporotic fracture assessment. Novel serum biomarkers, such as circulating microRNA, are emerging and showing potential for diagnosing osteoporosis and estimating fracture risk. A major aim of osteoporosis diagnosis is to clarify the origins of the disease, clarify the functions of biomarkers and their dynamic changes responding to therapy, and develop a novel diagnostic strategy in combination with current methods. Traditional therapeutics, including bisphosphonates, denosumab, oestrogen replacement, and teriparatide, have been used in osteoporosis therapy for a long time. Some severe side effects have resulted in therapy discontinuation; however, the incidence of adverse reactions is quite low. Developing novel treatments for osteoporosis using mesenchymal stem cells or Chinese medicinal herb-based therapy is of increasing interest to researchers, based on their improved safety, efficiency, and cost performance. Improvements in both diagnostic and therapeutic strategies may contribute to personalised management of osteoporosis.