Osteoporosis is a sexist disease with a much higher prevalence in women than in men, especially in postmenopausal women. Osteoporosis is a systemic bone disease that may be due to a variety of causes, including decreased bone density and quality, destruction of bone microarchitecture, resulting in increased bone fragility, and thus susceptibility to fracture. If the human body is compared to a building, then the bones are the reinforcing steel structure that supports the whole body, and osteoporosis is like the rusting of the reinforcing steel structure due to various factors, which eventually results in the loss of support and the collapse of the building. There are many causes of osteoporosis, besides endocrine diseases, blood system diseases, connective tissue diseases and secondary osteoporosis caused by drugs, the most important is the primary osteoporosis related to menopause and old age. Postmenopausal osteoporosis, also known as type I osteoporosis, is characterized by high-conversion osteoporosis, i.e., active bone resorption and bone formation, but with bone resorption as the main cause, and generally occurs within 5 to 10 years after menopause. Patients may have low back pain or circumferential aches and pains, and when the load increases the pain worsens or the activity is limited, and in severe cases there are difficulties in turning over, sitting up and walking, but because these symptoms are often confused with others such as rheumatoid arthritis, it leads to a lack of attention from patients, who often wait until a fracture is triggered and go to the hospital for an examination, only to find that it is caused by osteoporosis. Estrogen deficiency, genetic factors, nutritional status, lifestyle habits, physical exercise, menstrual cycle disorders, and menopause earlier than 40 years old are all related to the development of postmenopausal osteoporosis, of which postmenopausal estrogen deficiency is an important cause, which is also the reason why women have a significantly higher rate of osteoporosis and related fractures than men, and the risk of fracture is three times higher than that of men. BMD measurement by DEXA is an objective and reproducible measure of bone mass that can indirectly reflect bone strength and predict fracture risk, while dynamic observation can also show the rate of bone loss and can be used to diagnose osteoporosis. The treatment of postmenopausal osteoporosis is based on medication, exercise therapy and physical therapy. Pharmacological treatment (2011 China Osteoporosis Prevention and Control Guidelines) Primary osteoporosis guidelines The basis of pharmacological treatment is calcium and vitamin D Calcium: The recommended calcium intake for postmenopausal women by the National Institutes of Health (NIH) is about 1500 mg/d. Recent studies have found that calcium with estrogen treatment for postmenopausal osteoporosis can improve the efficacy. It is important to note that calcium should be given along with appropriate amounts of vitamin D to increase the absorption and utilization of calcium. However, calcium can reduce the absorption of iron, so calcium should not be consumed at the same time with foods containing a lot of iron. I. Bone resorption inhibitors Dilantin phosphate and estrogen-based hormone replacement therapy: It is the drug of choice for the treatment of postmenopausal osteoporosis without menopausal symptoms. In addition to inhibiting bone resorption by inhibiting parathyroid hormone, calcitonin and other calcium-regulating hormones and acting directly on osteoclasts, it can also promote the bone formation effect of osteoblasts. The main side effects are increased incidence of endometrial hyperplasia, endometrial cancer, and breast cancer. Progestin can be used in combination with estrogen to reduce the incidence of these risks. Calcitonin: In addition to inhibiting bone resorption, it has strong anti-inflammatory and central analgesic effects, and is more effective in severe pain caused by fractures in postmenopausal osteoporosis. The main side effects are nausea, vomiting, diarrhea, loss of appetite and other symptoms. Long-term application of calcitonin can occur hypocalcemia, so it can be appropriately combined with calcium, but is not preferred. Bone formation promoter Parathyroid hormone: It has obvious osteogenic effect in small doses, while it inhibits osteoblasts in large doses. Subcutaneous injection of PTH causes an intermittent increase in its concentration, which is beneficial to bone formation and the enhancement of bone resorption activity, and the increase in bone formation index is greater than the increase in bone resorption index, which is beneficial to bone formation. Fluoride: commonly used fluoride mainly includes sodium fluoride, slow-release sodium fluoride, and glutamine monofluorophosphate. Other bone formation promoters include androgens and anabolic hormones, insulin-like growth factors, selective estrogen receptor modulators, etc. Exercise therapy and physical therapy Regular and long-term exercise not only inhibits the decrease of bone density at the stress site, but also increases bone diameter and bone mineral content, which is important for preventing the progression of osteoporosis and fractures. Physical therapy such as phototherapy, laser, microwave and electromagnetic field therapy can be used as an adjunctive treatment for postmenopausal osteoporosis.