Psychosomatic interplay in postmenopausal osteoporosis: from neuroendocrine mechanisms to structured psychological therapies and long-term management.

Authors

Haixiang Zhang, Jihan Wang, Yangyang Wang, Cuixiang Xu, Zhankui Jin

Published in

Frontiers in psychiatry. Volume 17. Pages 1906383. Epub Aug 20, 2026.

Abstract

Postmenopausal osteoporosis (PMOP) is a prevalent chronic condition that severely compromises both the physical and psychological well-being of aging women. Beyond its skeletal implications, PMOP exhibits a profound psychosomatic interplay, intimately linked with elevated rates of depression and anxiety that frequently impair treatment adherence and functional recovery. This psychological vulnerability arises from a complex web of hormonal shifts, fear of fracture, and significant global sociocultural determinants that restrict care access. This comprehensive narrative review synthesizes current evidence through a biopsychosocial framework, critically examining the underlying psychoneuroimmunology (PNI) mechanisms that govern the bone-mood axis. Furthermore, we evaluate evidence-based psychological therapies (including cognitive behavioral therapy and mindfulness-based interventions) and propose an innovative, hierarchical stepped-care model for long-term patient management. Finally, we identify critical gaps in existing pharmacological and behavioral strategies, offering a multidisciplinary roadmap to advance mental health equity and integrated psychosomatic care for aging female populations.

PMID:
42694919
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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