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학습 자료 둘러보기 →The most significant risk factor is surgical menopause (bilateral oophorectomy) before age 45 without hormone replacement therapy (HRT). This causes an abrupt, complete loss of endogenous estrogen production.
Estrogen normally promotes osteoclast apoptosis and inhibits bone resorption. Its sudden deficiency leads to unopposed osteoclast activity, where bone resorption dramatically outpaces formation, resulting in rapid trabecular bone loss and microarchitectural deterioration.
A history of surgical menopause requires immediate bone density screening and consideration of HRT or other antiresorptive therapy, regardless of other lifestyle factors. Do not underestimate this risk compared to dietary or exercise-related factors.
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