{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:07:29Z","timestamp":1792228049876,"version":"4.4.0"},"reference-count":81,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Premature ovarian insufficiency is a reproductive endocrine disorder characterized by the cessation of ovarian function before the age of 40 years. Although the etiopathology of POI remains largely unknown, certain causative factors have been identified. Individuals affected by POI are at an increased risk of experiencing bone mineral density (BMD) loss. Hormonal replacement therapy (HRT) is recommended for patients with POI to mitigate the risk of decreased BMD, starting from the time of diagnosis until reaching the average age of natural menopause. Various studies have compared the dose-effect relationship of estradiol supplementation, as well as different HRT formulations on BMD. The impact of oral contraception on reduced BMD or the potential benefits of adding testosterone to estrogen replacement therapy are still subjects of ongoing discussion. This review provides an overview of the latest advancements in the diagnosis, evaluation, and treatment of POI as it relates to BMD loss.<\/jats:p>","DOI":"10.3390\/jcm12124042","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T02:01:40Z","timestamp":1686708100000},"page":"4042","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Managing Early Onset Osteoporosis: The Impact of Premature Ovarian Insufficiency on Bone Health"],"prefix":"10.3390","volume":"12","author":[{"given":"Blazej","family":"Meczekalski","sequence":"first","affiliation":[{"name":"Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Niwczyk","sequence":"additional","affiliation":[{"name":"Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Bala","sequence":"additional","affiliation":[{"name":"UCD School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Szeliga","sequence":"additional","affiliation":[{"name":"Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI, Webber, L., Davies, M., Anderson, R., Bartlett, J., Braat, D., Cartwright, B., Cifkova, R., de Muinck Keizer-Schrama, S., and Hogervorst, E. (2016). ESHRE Guideline: Management of women with premature ovarian insufficiency. Hum. Reprod., 31, 926\u2013937. Available online: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27008889.","DOI":"10.1093\/humrep\/dew027"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"588","DOI":"10.3109\/09513590.2013.788625","article-title":"Cytogenetic analysis of 179 Iranian women with premature ovarian failure","volume":"29","author":"Kalantari","year":"2013","journal-title":"Gynecol. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/humrep\/deh635","article-title":"Association of FMR1 repeat size with ovarian dysfunction","volume":"20","author":"Sullivan","year":"2005","journal-title":"Hum. Reprod."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Szeliga, A., Calik-Ksepka, A., Maciejewska-Jeske, M., Grymowicz, M., Smolarczyk, K., Kostrzak, A., Smolarczyk, R., Rudnicka, E., and Meczekalski, B. (2021). Autoimmune diseases in patients with premature ovarian insufficiency\u2014Our current state of knowledge. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052594"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.fertnstert.2011.10.040","article-title":"Impact of cancer therapies on ovarian reserve","volume":"97","author":"Gracia","year":"2012","journal-title":"Fertil. Steril."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/S0015-0282(16)41233-1","article-title":"Mumps oophoritis: A cause of premature menopause","volume":"26","author":"Morrison","year":"1975","journal-title":"Fertil. Steril."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"122","DOI":"10.4103\/jrms.JRMS_691_19","article-title":"Early menopause in acquired immunodeficiency syndrome","volume":"26","author":"Ahmed","year":"2021","journal-title":"J. Res. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"34.e1","DOI":"10.1016\/j.ajog.2011.02.059","article-title":"Factors associated with age of onset and type of menopause in a cohort of UK women","volume":"205","author":"Pokoradi","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105.e1","DOI":"10.1016\/j.jpeds.2010.06.054","article-title":"Age at onset of puberty predicts bone mass in young adulthood","volume":"158","author":"Gilsanz","year":"2011","journal-title":"J. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s00198-008-0751-7","article-title":"Genetic and environmental determinants on bone loss in postmenopausal Caucasian women: A 14-year longitudinal twin study","volume":"20","author":"Zhai","year":"2009","journal-title":"Osteoporos. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101616","DOI":"10.1016\/j.beem.2022.101616","article-title":"Acquisition of peak bone mass","volume":"36","author":"Chevalley","year":"2022","journal-title":"Best. Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_12","first-page":"1060","article-title":"Longitudinal monitoring of bone mass accumulation in healthy adolescents: Evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects","volume":"75","author":"Theintz","year":"1992","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s11684-020-0748-y","article-title":"Factors influencing peak bone mass gain","volume":"15","author":"Zhu","year":"2021","journal-title":"Front. Med."},{"key":"ref_14","first-page":"e128483","article-title":"A Review of the Effects of Physical Activity (PA) on Bone Density: Relying on Iranian Studies","volume":"11","author":"Azarbayjani","year":"2022","journal-title":"Thrita"},{"key":"ref_15","first-page":"4541","article-title":"Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls","volume":"84","author":"Zamora","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/MIB.0000000000001139","article-title":"Structural Basis of Bone Fragility in Young Subjects with Inflammatory Bowel Disease: A High-resolution pQCT Study of the SWISS IBD Cohort (SIBDC)","volume":"23","author":"Pepe","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jocd.2013.08.004","article-title":"Executive summary of the 2013 International Society for Clinical Densitometry Position Development Conference on bone densitometry","volume":"16","author":"Schousboe","year":"2013","journal-title":"J. Clin. Densitom. Off. J. Int. Soc. Clin. Densitom."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1179544119849017","DOI":"10.1177\/1179544119849017","article-title":"Comparison of Bone Mineral Densitometry at 2 Sites Versus 3 Sites in Patients Suspicious for Osteoporosis","volume":"12","author":"Azami","year":"2019","journal-title":"Clin. Med. Insights Arthritis Musculoskelet. Disord."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s11914-005-0005-y","article-title":"The relationship between bone mineral density and fracture risk","volume":"3","author":"McClung","year":"2005","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/S0140-6736(76)92217-0","article-title":"Long-term prevention of postmenopausal osteoporosis by oestrogen. Evidence for an increased bone mass after delayed onset of oestrogen treatment","volume":"1","author":"Lindsay","year":"1976","journal-title":"Lancet"},{"key":"ref_21","first-page":"2309","article-title":"Estrogen receptors alpha and beta are differentially expressed in developing human bone","volume":"86","author":"Bord","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1210\/me.2009-0354","article-title":"The estrogen receptor-alpha in osteoclasts mediates the protective effects of estrogens on cancellous but not cortical bone","volume":"24","author":"Almeida","year":"2010","journal-title":"Mol. Endocrinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1016\/j.yexcr.2009.01.014","article-title":"Estrogen inhibits RANKL-stimulated osteoclastic differentiation of human monocytes through estrogen and RANKL-regulated interaction of estrogen receptor-alpha with BCAR1 and Traf6","volume":"315","author":"Robinson","year":"2009","journal-title":"Exp. Cell. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.tem.2012.03.008","article-title":"Estrogen and the skeleton","volume":"23","author":"Khosla","year":"2012","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.physbeh.2009.04.025","article-title":"Estrogen regulation of apoptosis in osteoblasts","volume":"99","author":"Bradford","year":"2010","journal-title":"Physiol. Behav."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1210\/en.2011-1977","article-title":"Estrogen receptors \u03b1 and \u03b2 have different gender-dependent effects on the adaptive responses to load bearing in cancellous and cortical bone","volume":"153","author":"Saxon","year":"2012","journal-title":"Endocrinology."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E854","DOI":"10.1152\/ajpendo.90696.2008","article-title":"Estrogen receptor-alpha and -beta and aromatase knockout effects on lower limb muscle mass and contractile function in female mice","volume":"296","author":"Brown","year":"2009","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1210\/me.2007-0259","article-title":"Gone with the Wnts: Beta-catenin, T-cell factor, forkhead box O, and oxidative stress in age-dependent diseases of bone, lipid, and glucose metabolism","volume":"21","author":"Manolagas","year":"2007","journal-title":"Mol. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/jbmr.128","article-title":"Regulation of circulating sclerostin levels by sex steroids in women and in men","volume":"26","author":"Clowes","year":"2011","journal-title":"J. Bone Miner. Res. Off. J. Am. Soc. Bone Miner. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1001\/jama.1941.02820220007002","article-title":"Postmenopausal Osteoporosis: Its Clinical Features","volume":"116","author":"Albright","year":"1941","journal-title":"J. Am. Med. Assoc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/gme.0b013e31804c793d","article-title":"Effect of early menopause on bone mineral density and fractures","volume":"14 Pt. 2","author":"Gallagher","year":"2007","journal-title":"Menopause"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1210\/jc.2008-1878","article-title":"Bone Mineral Density in Estrogen-Deficient Young Women","volume":"94","author":"Popat","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/humrep\/dez259","article-title":"Age at natural menopause and development of chronic conditions and multimorbidity: Results from an Australian prospective cohort","volume":"35","author":"Xu","year":"2020","journal-title":"Hum. Reprod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"652","DOI":"10.3109\/09513590.2010.486452","article-title":"Hypoestrogenism in young women and its influence on bone mass density","volume":"26","author":"Meczekalski","year":"2010","journal-title":"Gynecol. Endocrinol. Off. J. Int. Soc. Gynecol. Endocrinol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1080\/13697137.2020.1804547","article-title":"Premature ovarian insufficiency: An International Menopause Society White Paper","volume":"23","author":"Panay","year":"2020","journal-title":"Climacteric"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1359\/jbmr.081108","article-title":"Hip fractures and the contribution of cortical versus trabecular bone to femoral neck strength","volume":"24","author":"Holzer","year":"2009","journal-title":"J. Bone Miner. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1634\/theoncologist.2012-0416","article-title":"A study to evaluate the cause of bone demineralization in gynecological cancer survivors","volume":"18","author":"Stavraka","year":"2013","journal-title":"Oncologist"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1210\/endrev\/bnab015","article-title":"The Relationship Between Bone and Reproductive Hormones Beyond Estrogens and Androgens","volume":"42","author":"Mills","year":"2021","journal-title":"Endocr. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3109\/09513590.2010.487599","article-title":"What is really responsible for bone loss in spontaneous premature ovarian failure? A new enigma","volume":"26","author":"Lana","year":"2010","journal-title":"Gynecol. Endocrinol. Off. J. Int. Soc. Gynecol. Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1080\/13697137.2020.1866530","article-title":"Androgens in premenopausal women and women with premature ovarian insufficiency","volume":"24","author":"Davis","year":"2021","journal-title":"Climacteric"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1080\/13697137.2021.1917539","article-title":"New insights into the diagnosis and management of bone health in premature ovarian insufficiency","volume":"24","author":"Nguyen","year":"2021","journal-title":"Climacteric"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1080\/09513590.2016.1257602","article-title":"Standard hormone therapy is inadequate for bone density in premature ovarian insufficiency","volume":"33","author":"Giraldo","year":"2017","journal-title":"Gynecol. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1007\/s00198-002-1345-4","article-title":"Bone strength and its determinants","volume":"14","author":"Ammann","year":"2003","journal-title":"Osteoporos. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jocd.2007.12.010","article-title":"Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: The 2007 ISCD Official Positions","volume":"11","author":"Engelke","year":"2008","journal-title":"J. Clin. Densitom. Off. J. Int. Soc. Clin. Densitom."},{"key":"ref_45","first-page":"11","article-title":"Bone mineral density measurements for diagnosis of osteoporosis and the risk assessment","volume":"14","author":"Kushida","year":"2004","journal-title":"Clin. Calcium."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1097\/CORR.0000000000001842","article-title":"Is There an Association Between Bone Microarchitecture and Fracture in Patients who were Treated for High-grade Osteosarcoma? A Controlled Study at Long-term Follow-up Using High-resolution Peripheral Quantitative CT","volume":"479","author":"Holzer","year":"2021","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/s11657-018-0510-0","article-title":"A brief history of FRAX","volume":"13","author":"Kanis","year":"2018","journal-title":"Arch. Osteoporos."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"3792","DOI":"10.1210\/jc.2018-00854","article-title":"A Cross-Sectional and Longitudinal Analysis of Trabecular Bone Score in Adults with Turner Syndrome","volume":"103","author":"Nguyen","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1210\/jc.2017-02381","article-title":"A 6-Year Follow-Up of Fracture Incidence and Volumetric Bone Mineral Density Development in Girls with Turner Syndrome","volume":"103","author":"Soucek","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5114\/pm.2018.78552","article-title":"Bone health and evaluation of bone mineral density in patients with premature ovarian insufficiency","volume":"17","author":"Szeliga","year":"2018","journal-title":"Prz. Menopauzalny Menopause Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.maturitas.2020.11.004","article-title":"Premature ovarian insufficiency: A toolkit for the primary care physician","volume":"147","author":"Lambrinoudaki","year":"2021","journal-title":"Maturitas"},{"key":"ref_52","unstructured":"(2023, April 25). Overview of the Management of Osteoporosis in Postmenopausal Women\u2014UpToDate. Available online: http:\/\/han.ump.edu.pl\/han\/uptodatebazydanych\/https\/www.uptodate.com\/contents\/overview-of-the-management-of-osteoporosis-in-postmenopausal-women?search=prematureovarianinsufficiency&topicRef=7426&source=see_link#H3."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Podfigurna, A., Maciejewska-Jeske, M., Nadolna, M., Mikolajska-Ptas, P., Szeliga, A., Bilinski, P., Napierala, P., and Meczekalski, B. (2020). Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients. J. Clin. Med., 9.","DOI":"10.3390\/jcm9123961"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"dgaa406","DOI":"10.1210\/clinem\/dgaa406","article-title":"Effects of Hormone Replacement Therapy on Bone Mass After Allogeneic Hematopoietic Stem Cell Transplantation","volume":"105","author":"Ha","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1210\/jc.2015-4063","article-title":"Hormone Replacement Therapy Versus the Combined Oral Contraceptive Pill in Premature Ovarian Failure: A Randomized Controlled Trial of the Effects on Bone Mineral Density","volume":"101","author":"Cartwright","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1080\/13697137.2021.1902496","article-title":"Premature ovarian insufficiency: The need for evidence on the effectiveness of hormonal therapy","volume":"24","author":"Upton","year":"2021","journal-title":"Climacteric"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.maturitas.2022.09.011","article-title":"Impact of hormone therapy on the bone density of women with premature ovarian insufficiency: A systematic review","volume":"167","author":"Costa","year":"2023","journal-title":"Maturitas"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.mayocp.2017.11.002","article-title":"The International Society for the Study of Women\u2019s Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women","volume":"93","author":"Clayton","year":"2018","journal-title":"Mayo Clin. Proc."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00042192-200007040-00007","article-title":"Administration of testosterone undecanoate in postmenopausal women: Effects on androgens, estradiol, and gonadotrophins","volume":"7","year":"2000","journal-title":"Menopause"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1080\/13697130701600815","article-title":"Osteoporosis: Non-hormonal treatment","volume":"10","author":"Rizzoli","year":"2007","journal-title":"Climacteric"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s00198-012-2179-3","article-title":"A meta-analysis characterizing the dose-response relationships for three oral nitrogen-containing bisphosphonates in postmenopausal women","volume":"24","author":"Yates","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"43399","DOI":"10.1038\/srep43399","article-title":"Long-term effects of bisphosphonate therapy: Perforations, microcracks and mechanical properties","volume":"7","author":"Ma","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/2053369117699358","article-title":"The British Menopause Society and Women\u2019s Health Concern recommendations on the management of women with premature ovarian insufficiency","volume":"23","author":"Hamoda","year":"2017","journal-title":"Post. Reprod. Health"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"(2017). Committee Opinion, No. 698: Hormone Therapy in Primary Ovarian Insufficiency. Obstet. Gynecol., 129, e134\u2013e141.","DOI":"10.1097\/AOG.0000000000002044"},{"key":"ref_65","first-page":"174","article-title":"The management of menopausal sequelae in patients with breast cancer","volume":"13","author":"Rostom","year":"2001","journal-title":"Clin. Oncol. R. Coll. Radiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1007\/s00520-015-2915-2","article-title":"Zoledronic acid for treatment of osteopenia and osteoporosis in women with primary breast cancer undergoing adjuvant aromatase inhibitor therapy: A 5-year follow-up","volume":"24","author":"Majithia","year":"2016","journal-title":"Support. Care Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/S1470-2045(11)70122-X","article-title":"Adjuvant endocrine therapy plus zoledronic acid in premenopausal women with early-stage breast cancer: 62-month follow-up from the ABCSG-12 randomised trial","volume":"12","author":"Gnant","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3864","DOI":"10.1210\/jc.2011-1038","article-title":"Resumption of Ovarian Function and Pregnancies in 358 Patients with Premature Ovarian Failure","volume":"96","author":"Bidet","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"280","DOI":"10.14310\/horm.2002.1319","article-title":"The use of bisphosphonates in women prior to or during pregnancy and lactation","volume":"10","author":"Stathopoulos","year":"2011","journal-title":"Hormones"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1503\/cmaj.060781","article-title":"Osteoporosis treatment: Raloxifene (Evista) and stroke mortality","volume":"175","author":"Wooltorton","year":"2006","journal-title":"C. Can. Med. Assoc. J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1001\/jama.281.23.2189","article-title":"The effect of raloxifene on risk of breast cancer in postmenopausal women: Results from the MORE randomized trial","volume":"281","author":"Cummings","year":"1999","journal-title":"JAMA"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s12325-021-01936-y","article-title":"Denosumab in the Treatment of Osteoporosis: 10 Years Later: A Narrative Review","volume":"39","author":"Kendler","year":"2022","journal-title":"Adv. Ther."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"4029","DOI":"10.2147\/DDDT.S270829","article-title":"A Review on the Role of Denosumab in Fracture Prevention","volume":"14","author":"Pang","year":"2020","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4172\/2161-0509.1000189","article-title":"Effects of Denosumab Treatment during Early Pregnancy\u2014A Case Report","volume":"6","author":"Isobe","year":"2015","journal-title":"J. Nutr. Disord. Ther."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00198-007-0490-1","article-title":"Salmon calcitonin: A review of current and future therapeutic indications","volume":"19","author":"Chesnut","year":"2008","journal-title":"Osteoporos. Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00198-014-2937-5","article-title":"Nasal salmon calcitonin blunts bone microstructure alterations in healthy postmenopausal women","volume":"26","author":"Rizzoli","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1007\/s11914-013-0171-2","article-title":"Parathyroid hormone and parathyroid hormone-related protein analogs as therapies for osteoporosis","volume":"11","author":"Augustine","year":"2013","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1056\/NEJM200105103441904","article-title":"Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis","volume":"344","author":"Neer","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1080\/01926230252929882","article-title":"Skeletal changes in rats given daily subcutaneous injections of recombinant human parathyroid hormone (1-34) for 2 years and relevance to human safety","volume":"30","author":"Vahle","year":"2002","journal-title":"Toxicol. Pathol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/1759720X13483187","article-title":"A review on strontium ranelate long-term antifracture efficacy in the treatment of postmenopausal osteoporosis","volume":"5","author":"Cianferotti","year":"2013","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1210\/jc.2004-1774","article-title":"Strontium Ranelate Reduces the Risk of Nonvertebral Fractures in Postmenopausal Women with Osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) Study","volume":"90","author":"Reginster","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/4042\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:54:29Z","timestamp":1760126069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/12\/4042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,14]]},"references-count":81,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["jcm12124042"],"URL":"https:\/\/doi.org\/10.3390\/jcm12124042","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,14]]}}}