Which pair are two major risk factors for osteoporosis in postmenopausal women?

• A. Estrogen deficiency due to menopause and aging
• B. Vitamin D deficiency and high calcium intake
• C. Sedentary lifestyle and excessive sun exposure
• D. Male gender and normal bone density

Answer: (A)

Postmenopausal osteoporosis is driven mainly by two factors: the dropping level of estrogen after menopause and the effect of aging itself. Estrogen helps keep bone density by inhibiting bone resorption; when estrogen declines, osteoclast activity increases, leading to faster loss of bone, especially in the spine and hips. Aging compounds this by years of ongoing remodeling with less new bone formation and other age-related changes that reduce bone strength. Together, these two factors explain why postmenopausal women are at high risk for osteoporosis and fractures.

Other options aren’t the strongest pair for this scenario. Vitamin D deficiency can worsen bone health, but high calcium intake isn’t a risk factor. Sedentary lifestyle is a risk, but excessive sun exposure increases vitamin D and is not a risk for osteoporosis. Male gender and normal bone density are protective factors, not risk factors, in this context.