Evidence map›Paper›PMID 41020017›Full record

ArticleCureus2025

Hormonal Changes During Menopause and Their Impact on Bone Health: Insights from Orthopedic and Reproductive Medicine.

Shahmeen Rasul, Yashar Mashayekhi, Maria Javaid, Sami Merie, Marwah A Khalaf, Talha Ahmed, Muhammad Haris, Imtiaz Mustafa

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shahmeen RasulDepartment of Trauma and Orthopaedics, Royal Free Hospital, London, GBR.
Yashar MashayekhiDepartment of Medicine, Leicester University Hospital, Leicester, GBR.
Maria JavaidDepartment of Obstetrics and Gynaecology, Hameed Latif Teaching Hospital, Lahore, PAK.
Sami MerieDepartment of Trauma and Orthopaedics, University Hospital Lewisham, London, GBR.
Marwah A KhalafDepartment of Community Health Nursing, College of Nursing, University of Kirkuk, Kirkuk, IRQ.
Talha AhmedDepartment of Trauma and Orthopaedics, University Hospitals Dorset, Poole Hospital, Poole, GBR.
Muhammad HarisDepartment of Internal Medicine, King Edward Medical University, Lahore, PAK.
Imtiaz MustafaInstitute of Molecular Biology and Biotechnology, Center for Research in Molecular Medicine, The University of Lahore, Lahore, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background Menopause is characterized by profound hormonal alterations, including a decline in estradiol and progesterone with compensatory rises in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These changes have been implicated in the pathogenesis of bone loss and osteoporosis, yet their precise contribution in the South Asian population remains underexplored. This study aimed to investigate the relationship between hormonal changes during menopause and their impact on bone health, with integrated perspectives from orthopedic and reproductive medicine. Methods A retrospective study was conducted at the University of Lahore, Lahore, Pakistan, utilizing medical records of postmenopausal women aged 45-65 years over a 12-month period. A total of 180 participants with complete hormonal and bone health data were included through purposive sampling. Data collected included demographic characteristics, menopausal duration, lifestyle factors, serum hormone levels (estradiol, progesterone, FSH, LH), biochemical markers (serum calcium, vitamin D, alkaline phosphatase), and bone mineral density (BMD) assessed via dual-energy X-ray absorptiometry (DEXA). Statistical analyses included t-tests, chi-square tests, Pearson's correlation, and multivariate linear regression, with p < 0.05 considered significant. Results Women with menopause ≥5 years exhibited significantly lower estradiol (21.4 ± 8.6 pg/mL vs. 36.8 ± 12.4 pg/mL, p < 0.001) and higher FSH (68.7 ± 12.5 mIU/mL vs. 51.6 ± 9.4 mIU/mL, p < 0.001). Lumbar spine BMD was markedly reduced in this group (0.81 ± 0.13 g/cm² vs. 0.94 ± 0.11 g/cm², p < 0.001), with higher rates of osteopenia (49.1%) and osteoporosis (25.5%). Biochemical markers showed lower calcium and vitamin D, alongside elevated alkaline phosphatase. Correlation analysis demonstrated a positive association between estradiol and BMD (r = 0.46, p < 0.001) and a negative association with FSH (r = -0.39, p < 0.001). Multivariate regression identified estradiol as the strongest positive predictor and FSH as the strongest negative predictor of BMD, independent of age, BMI, and lifestyle factors. Conclusion Hormonal shifts during menopause, particularly reduced estradiol and elevated FSH, exert a dominant influence on bone health deterioration, surpassing the effects of age, BMI, and lifestyle. Early identification and targeted interventions addressing endocrine changes may be crucial for mitigating osteoporosis risk in postmenopausal women.

Indexed as

bone mineral densityestrogenmenopauseorthopedic-endocrine linkosteoporosis

Identifiers

PMID41020017
PMCPMC12464279

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.