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recommendations of the National Academy of Sciences, 400 is believed to influence through increased metabolism of
IU of vitamin D per day is required for healthy younger indi- estrogen and direct action of cadmium on bone metaboli-
viduals. For individuals over 50 years of age, the recommen- sm.
dations are 800 to 1.000 IU per day. Some experts even re-
commend significantly higher doses, up to 2.000 IU per day. Regular physical activity, such as daily walks lasting 30
Current recommendations for minimum levels of 25(OH)D minutes and exercises for about 10 minutes several times a
are 30-32 ng/mL, while the upper limits are up to 60 ng/mL. week, contributes to maintaining a healthy skeletal system.
Meta-analytical studies indicate that supplementation with Research indicates that muscle strength in younger women
vitamin D at doses of 700-800 IU per day reduces the risk positively correlates with bone density. However, physical
of fractures in postmenopausal women. For patients with activity in older individuals should be individually tailored
severe vitamin D deficiency, vitamin D supplementation can according to age and the patient's overall condition.
go up to 2,000 IU or more per day . Furthermore, education on fall prevention and conse-
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Increased alcohol consumption has a negative effect on quent fractures is also recommended .
bone health, as it increases the risk of fractures. The way al- It is important to note that phytoestrogens also re-
cohol affects bones is complex, multifactorial, and increases present an option for osteoporosis prevention in women.
the risk of falls, calcium deficiency, and chronic liver overlo- Phytoestrogens are believed to influence bone health. Soy
ad. Also, it is not recommended to consume more than 1-2 isoflavones, functionally similar to 17-beta-estradiol, exhibit
cups of coffee per day because some studies have indicated activity on osteoblasts and osteoclasts through genomic
a positive association between caffeine and the risk of fra- and non-genomic mechanisms and have a favorable effect
ctures, most likely due to reduced calcium intake. on bone mineral density and mechanical strength in pos-

Cigarette smoking significantly affects bone health. The tmenopausal women, contributing to bone formation by
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exact mechanism of action is not fully understood, but it acting through estrogen receptors on the cell surface .

Conclusion

Postmenopausal osteoporosis is a silent but progressive disease that is highly prevalent worldwide.
It represents a chronic condition that is asymptomatic, and its progression is slow. Numerous
studies on this issue have identified etiopathogenetic factors and mechanisms of onset along with
documented risk factors. Without proper and timely diagnosis and treatment, postmenopausal

osteoporosis can lead to a significant decline in quality of life. Efforts need to be made to educate
postmenopausal women about necessary lifestyle modifications even during the perimenopausal
period to prevent this disorder.

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