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Background: Menopausal osteoporosis (Type I osteoporosis) is a systemic skeletal disorder driven by the sharp decline in oestrogen following natural or surgical menopause, resulting in accelerated bone resorption, reduced bone mineral density (BMD), and heightened risk of fragility fractures. It affects an estimated 200 million women globally, with India reporting over 46 million at-risk post-menopausal women. Despite available pharmacological options—bisphosphonates, selective oestrogen receptor modulators (SERMs), and denosumab—long-term therapeutic compliance remains poor due to adverse effects. This has intensified clinical interest in complementary and integrative approaches. Homoeopathy, through individualised constitutional prescribing based on the principle of similia similibus curentur, and evidence-informed dietary management together represent a compelling multi-dimensional strategy for bone health in post-menopausal women.

Methods: A comprehensive narrative review was conducted using literature from PubMed, Scopus, Google Scholar, and AYUSH Research Portal, covering publications from 1988 to 2024. Search terms included: 'menopausal osteoporosis,' 'postmenopausal bone loss,' 'homoeopathy AND osteoporosis,' 'Calcarea Carbonica bone,' 'Symphytum bone healing,' 'phytoestrogens AND BMD,' 'calcium Vitamin D fracture prevention,' and 'anti-inflammatory diet bone health.' Inclusion criteria comprised original research articles, systematic reviews, meta-analyses, and authoritative materia medica texts. Seventeen peer-reviewed references were selected and synthesised; homoeopathic materia medica sources (Kent, Boericke, Schuessler) were incorporated for remedy profiling.

Results: The pathophysiology centres on oestrogen withdrawal-induced upregulation of RANKL and suppression of osteoprotegerin (OPG), driving net osteoclast dominance and progressive bone loss of 2–8% annually in early post-menopausal years. Ten key homoeopathic remedies—including Calcarea Carbonica, Calcarea Phosphorica, Symphytum Officinale, Silicea, Phosphorus, Sepia, Lachesis, Ruta Graveolens, Fluoric Acid, and Natrum Muriaticum—were identified with well-characterised constitutional and musculoskeletal profiles. Biochemic tissue salts (Calc. Phos. 6X, Calc. Fluor. 12X, Silicea 12X) were identified as adjunctive bone-mineralisation supports. Dietary analysis confirmed that post-menopausal women require 1,000–1,200 mg/day of elemental calcium, 800–2,000 IU/day of Vitamin D3, and 40–80 mg/day of soy isoflavone aglycones—the latter associated with a ~54% reduction in lumbar spine bone loss versus placebo. Ragi (Eleusine coracana, 344 mg calcium/100g) was highlighted as a culturally appropriate high-calcium Indian dietary staple.

Discussion: Homoeopathic constitutional treatment addresses the whole-person vulnerability underlying menopausal osteoporosis—including miasmatic predisposition, defective calcium assimilation, and menopausal symptom burden—in a manner complementary to, rather than replacing, conventional antiresorptive pharmacotherapy when fracture risk thresholds indicate intervention. The integrative framework proposed combines FRAX-guided risk stratification, homoeopathic constitutional prescribing, targeted nutritional optimisation, weight-bearing exercise, and fall-prevention strategies. Limitations include the sparse RCT evidence base for homoeopathic interventions and the predominance of Western populations in nutritional epidemiology studies.

Conclusion: Menopausal osteoporosis is optimally managed through an integrative, patient-centred approach. Homoeopathic constitutional prescribing and evidence-based dietary strategies—particularly calcium, Vitamin D, phytoestrogens, and anti-inflammatory foods from the Indian dietary tradition—constitute meaningful, accessible, and well-tolerated adjuncts to conventional bone health management. This review advocates for trans-disciplinary research and clinical collaboration to establish rigorous protocols within the integrative medicine framework endorsed by J-AIM.

Keywords: Menopausal osteoporosis; Homoeopathy; Bone mineral density; Calcarea Carbonica; Symphytum Officinale; Phytoestrogens; Dietary management; Post-menopausal women; Integrative medicine; RANKL/OPG axis