The role of resistance training in the prevention of osteoporosis in postmenopausal women – a narrative review
DOI:
https://doi.org/10.12775/JEHS.2026.95.72855Keywords
osteoporosis, postmenopausal woman, resistance training, bone mineral density, exercise therapy, fractureAbstract
Introduction: Postmenopausal osteoporosis is a common metabolic bone disease characterized by reduced bone mineral density (BMD) and an increased risk of fractures. Estrogen deficiency accelerates bone resorption, leading to progressive bone loss and impaired skeletal strength. Resistance training has gained attention as a non-pharmacological strategy for osteoporosis prevention due to its ability to stimulate bone remodeling through mechanical loading.
Objective: To evaluate the effects of resistance training on bone mineral density, fracture risk, and musculoskeletal function in postmenopausal women based on current scientific evidence.
Materials and methods: A narrative literature review was conducted using studies indexed in the PubMed database. Publications from 2015–2026 concerning resistance training and osteoporosis prevention in postmenopausal women were included. Earlier landmark studies were also considered when relevant.
Results: The reviewed studies indicate that resistance training is an effective intervention for preventing postmenopausal osteoporosis. Most studies reported stabilization or modest increases in BMD, particularly in the lumbar spine and femoral neck. The effectiveness of training was influenced by exercise intensity, duration, and progressive overload. Moderate- to high-intensity, long-term programs produced the most favorable outcomes, whereas low-intensity or short-term interventions showed limited effects. Although evidence regarding fracture reduction remains inconclusive, improvements in muscle strength, balance, and fall prevention may indirectly decrease fracture risk.
Conclusions: Resistance training appears to be a beneficial non-pharmacological approach for maintaining bone health in postmenopausal women. Regular participation may improve BMD and support fracture prevention. Further research is needed to establish standardized training protocols and optimize exercise recommendations.
References
1.Sozen T, Ozisik L. An overview and management of osteoporosis. European Journal of Rheumatology. 2019;4(1):46-56.
doi:https://doi.org/10.5152/eurjrheum.2016.048
2.Chin KY, Ng BN, Rostam MKI, et al. A Mini Review on Osteoporosis: From Biology to Pharmacological Management of Bone Loss. Journal of Clinical Medicine. 2022;11(21):6434. doi:https://doi.org/10.3390/jcm11216434
3.Cheng CH, Chen LR, Chen KH. Osteoporosis Due to Hormone Imbalance: An Overview of the Effects of Estrogen Deficiency and Glucocorticoid Overuse on Bone Turnover. International Journal of Molecular Sciences. 2022;23(3):1376. doi:https://doi.org/10.3390/ijms23031376
4.Wang LT, Chen LR, Chen KH. Hormone-Related and Drug-Induced Osteoporosis: A Cellular and Molecular Overview. International Journal of Molecular Sciences. 2023;24(6):5814.
doi:https://doi.org/10.3390/ijms24065814
5.Kumar S, Smith C, Clifton-Bligh RJ, Beck BR, Girgis CM. Exercise for Postmenopausal Bone Health – Can We Raise the Bar? Current Osteoporosis Reports. 2025;23(1). doi:https://doi.org/10.1007/s11914-025-00912-7
6.Shojaa M, von Stengel S, Kohl M, Schoene D, Kemmler W. Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporosis International. 2020;31(8):1427-1444.
doi:https://doi.org/10.1007/s00198-020-05441-w
7.Massini DA, Nedog FH, de Oliveira TP, et al. The Effect of Resistance Training on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis. Healthcare. 2022;10(6):1129.
doi:https://doi.org/10.3390/healthcare10061129
8.Wang Z, Zan X, Li Y, Lu Y, Xia Y, Pan X. Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: A systematic review and network meta-analysis. Frontiers in Physiology. 2023;14(Volume 14 + Article ID 1105303). doi:https://doi.org/10.3389/fphys.2023.1105303
9.Chang X, Xu S, Zhang H. Regulation of bone health through physical exercise: Mechanisms and types. Frontiers in Endocrinology. 2022;13(1). doi:https://doi.org/10.3389/fendo.2022.1029475
10.Zhao F, Su W, Sun Y, Wang J, Lu B, Yun H. Optimal resistance training parameters for improving bone mineral density in postmenopausal women: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025;20(1). doi:https://doi.org/10.1186/s13018-025-05890-1
11.Choi JUA, Kijas AW, Lauko J, Rowan AE. The Mechanosensory Role of Osteocytes and Implications for Bone Health and Disease States. Frontiers in Cell and Developmental Biology. 2022;9(0).
doi:https://doi.org/10.3389/fcell.2021.770143
12.Tobeiha M, Moghadasian MH, Amin N, Jafarnejad S. RANKL/RANK/OPG Pathway: A Mechanism Involved in Exercise-Induced Bone Remodeling. BioMed Research International. 2020;2020(0):1-11.
doi:https://doi.org/10.1155/2020/6910312
13.Li X, Kordsmeier J, Xiong J. New Advances in Osteocyte Mechanotransduction. Current Osteoporosis Reports. 2021;19(1):101-106.
doi:https://doi.org/10.1007/s11914-020-00650-y
14.Bonewald LF. Mechanosensation and transduction in osteocytes. BoneKEy-Osteovision. 2006;3(10):7-15.
doi:https://doi.org/10.1138/20060233
15.Zhang W, Li X, He Q, Wang X. Effects of exercise on bone metabolism in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Endocrinology. 2025;16(0). doi:https://doi.org/10.3389/fendo.2025.1597046
16.Weitzmann MN. Bone and the Immune System. Toxicologic Pathology. 2017;45(7):911-924.
doi:https://doi.org/10.1177/0192623317735316
17.O’Brien CA, Nakashima T, Takayanagi H. Osteocyte control of osteoclastogenesis. Bone. 2013;54(2):258-263.
doi:https://doi.org/10.1016/j.bone.2012.08.121
18.Ginaldi L, Di Benedetto M, De Martinis M. Osteoporosis, inflammation and ageing. Immunity & Ageing. 2005;2(1):14.
doi:https://doi.org/10.1186/1742-4933-2-14
19.Clarke BL, Khosla S. Physiology of Bone Loss. Radiologic Clinics of North America. 2010;48(3):483-495.
doi:https://doi.org/10.1016/j.rcl.2010.02.014
20.Manolagas SC, O’Brien CA, Almeida M. The role of estrogen and androgen receptors in bone health and disease. Nature reviews Endocrinology. 2013;9(12):699-712. doi:https://doi.org/10.1038/nrendo.2013.179
21.Hughes JM, Castellani CM, Popp KL, et al. The Central Role of Osteocytes in the Four Adaptive Pathways of Bone’s Mechanostat. Exercise and Sport Sciences Reviews. 2020;48(3):140-148.
doi:https://doi.org/10.1249/jes.0000000000000225
22.Uda Y, Azab E, Sun N, Shi C, Pajevic PD. Osteocyte Mechanobiology. Current Osteoporosis Reports. 2017;15(4):318-325.
doi:https://doi.org/10.1007/s11914-017-0373-0
23.Sheng MHC, Lau KHW, Baylink DJ. Role of Osteocyte-derived Insulin-Like Growth Factor I in Developmental Growth, Modeling, Remodeling, and Regeneration of the Bone. Journal of Bone Metabolism. 2014;21(1):41.
doi:https://doi.org/10.11005/jbm.2014.21.1.41
24.Terkawi MA, Matsumae G, Shimizu T, Takahashi D, Kadoya K, Iwasaki N. Interplay between Inflammation and Pathological Bone Resorption: Insights into Recent Mechanisms and Pathways in Related Diseases for Future Perspectives. International Journal of Molecular Sciences. 2022;23(3):1786.
doi:https://doi.org/10.3390/ijms23031786
25.Epsley S, Tadros S, Farid A, Kargilis D, Mehta S, Rajapakse CS. The Effect of Inflammation on Bone. Frontiers in Physiology. 2021;11(0). doi:https://doi.org/10.3389/fphys.2020.511799
26.Mohebbi R, Shojaa M, Kohl M, et al. Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis International. 2023;34(7). doi:https://doi.org/10.1007/s00198-023-06682-1
27.Kemmler W, Shojaa M, Kohl M, von Stengel S. Effects of Different Types of Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis. Calcified Tissue International. 2020;107(5):409-439. doi:https://doi.org/10.1007/s00223-020-00744-w
28.Walsh GS, Delextrat A, Bibbey A. The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials. Maturitas. 2023;175(0):107790. doi:https://doi.org/10.1016/j.maturitas.2023.107790
29.Hsu HH, Chiu CY, Chen WC, Yang YR, Wang RY. Effects of exercise on bone density and physical performance in postmenopausal women: A systematic review and meta-analysis. PM & R : the journal of injury, function, and rehabilitation. 2024;16(12):1358-1383.
doi:https://doi.org/10.1002/pmrj.13206
30.Dent E, Daly RM, Hoogendijk EO, Scott D. Exercise to Prevent and Manage Frailty and Fragility Fractures. Current Osteoporosis Reports. 2023;21(2). doi:https://doi.org/10.1007/s11914-023-00777-8
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