The Role of Vitamin D and Micronutrient Supplementation in Preventing Osteoporosis in Postmenopausal Women

Abstract

Osteoporosis is a major skeletal disorder characterised by reduced bone mineral density and deteriorating microarchitecture, imposing a considerable burden of fragility fractures on postmenopausal women worldwide (Compston, McClung and Leslie, 2019). The estrogen withdrawal that accompanies menopause accelerates bone resorption, tipping the remodelling balance toward net bone loss and increasing fracture vulnerability within the first decade after the final menstrual period (Cummings and Melton, 2002). Vitamin D, calcium, and a growing number of accessory micronutrients—including vitamin K2 and magnesium—play interrelated and mechanistically distinct roles in maintaining skeletal integrity (Capozzi, Scambia and Lello, 2020). This narrative review synthesises current evidence on the biology of bone loss after menopause, the contributions of individual micronutrients, clinical data on supplementation efficacy, diagnostic standards, management strategies, and the integration of nutritional support with pharmacologic therapy. Evidence indicates that vitamin D and calcium together modestly reduce fracture incidence and preserve bone mineral density, though benefits depend heavily on baseline nutritional status, dosing regimen, and patient adherence (Liu et al., 2020). Vitamin K2 and magnesium represent emerging adjuncts whose mechanistic rationale is compelling, although large randomised controlled trial data remain incomplete (Ma et al., 2022; Rondanelli et al., 2021). The review concludes that micronutrient optimisation is a necessary but insufficient sole strategy; it must be embedded within broader preventive and pharmacologic frameworks to achieve meaningful reductions in postmenopausal fracture risk.