Estrogen Deficiency During Menopause: Consequences for Bone Metabolism and Cardiovascular Health

 Menopausal  estrogen  decline  coincides  with  accelerated  skeletal  remodeling, redistribution of adipose tissue, adverse cardiometabolic changes and  increasing  cardiovascular  risk.  Distinguishing  hormonal  mechanisms  from  aging,  behavioral changes and healthcare selection is necessary before attributing clinical  events  to  estrogen  deficiency  alone.  Objective:  To  critically  integrate  mechanistic  research,  clinical  guidance,  randomized  evidence  and  observational  data  on  bone metabolism  and  cardiovascular  health  after  menopause,  while  examining  the  relevance of real-world evidence and artificial intelligence.