The cessation of ovarian function at the menopause is associated with a phase of rapid bone loss which probably lasts from 5 to 10 years (Genant et al, 1982; Recker et al, 2000). This rapid bone loss results from an increase in bone turnover in association with a negative remodelling imbalance (Compston, 2001); whilst reduced bone formation undoubtedly contributes to the latter, there is evidence that increased osteoclastic activity also plays a role, particularly in the earlier stages of menopausal bone loss (Compston et al, 1995). The combination of increased bone turnover and increased resorption depth results in disruption of bone microarchitecture, with loss of connectivity of.
