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Minerva Obstetrics and Gynecology 2021 Jul 30

DOI: 10.23736/S2724-606X.21.04893-4


language: English

Rethinking of osteoporosis through a sex- and gender-informed approach in the COVID-19 era

Alessandra VIOLI 1, Valeria FORTUNATO 1, Andrea D’AMURI 1, Giovanni ZULIANI 1, Stefania BASILI 2, Angelina PASSARO 1, Bernadette CORICA 2, Valeria RAPARELLI 1, 3, 4

1 University Internal Medicine Unit, Department of Translational Medicine, University of Ferrara, Ferrara, Italy; 2 Internal Medicine Clinic, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy; 3 Faculty of Nursing, University of Alberta, Edmonton, Canada; ⁴ University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy


Standards and models of reference for osteoporosis (OP) have been developed for female individuals as they are more likely to be affected by the disease. Nonetheless, OP is also responsible for one-third of hip fractures in male individuals suggesting that a sexblinded approach to OP may lead to miss opportunities for equity in bone health. OPrelated fractures, especially hip fractures, are a matter of immediate concern as they are associated with limited mobility, chronic disability, loss of independence, and reduced quality of life in both sexes. When it comes to sociocultural gender, the effect of gender domains (i.e., identity, roles, relations, and institutionalized gender) on development and management of OP is largely overlooked despite risk factors or protective conditions are gendered. Clinical trials testing the efficacy and safety of anti-OP drugs as well as non-pharmacological interventions have been conducted mainly in female participants, limiting the generalizability of the findings. The present narrative review deals with the sex and gender-based challenges and drawbacks in OP knowledge and translation to clinical practice, also considering the impact of coronavirus disease 2019 pandemic.

KEY WORDS: Osteoporosis; Sex; Epidemiology; COVID-19; Clinical trials

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