Bone Loss and Bone Size after Menopause

From the Departments of Orthopedics (H.G.A., O.J., M.K.K.) and Obstetrics and Gynecology (G.R.), Malmö University Hospital, Malmö, Sweden; and the Department of Orthopedic Surgery and the Biomechanics and Biomaterials Research Center, Indiana University, Indianapolis (C.H.T.). Address reprint requests to Dr. Ahlborg at the Department of Orthopedics, Malmö University Hospital, SE-205 02 Malmö, Sweden, or at [email protected]. N Engl J Med 2003;349:327-34. Copyright © 2003 Massachusetts Medical Society. background Bone loss increases after menopause. However, bone strength also depends on structural characteristics such as bone size. Whether bone size increases as a result of periosteal apposition and whether a strength index accounting for both bone density and bone size might predict the risk of fracture better than bone density alone are unclear.