Hip fractures represent a general public health problem due to their high incidence and their impact on mortality and loss of quality of life [1]. In the coming years, with the progressive aging of the population, its incidence is expected to increase, incurring a significant drain on resources [2]. Crude mortality figures after a hip fracture are considered in most studies. An estimated 5% of patients die in-hospital and approximately 20% do so during the first year, depending on the series [3]. However, hip fractures occur in elderly patients who have an associated comorbidity that also influences their survival [4]. The highest mortality rates are reported mainly in the elderly, sick or disabled populations [5]. A recent meta-analysis exploring the magnitude and duration of the excess risk of mortality after hip fracture found the highest risk in the first 3 months after the fracture, and mortality remained high even after 10 years [6]. Excess risk increases with age and, at any age, is higher for men than for women [6].

Osteoporosis is defined as a skeletal disease in which there is a decrease in bone strength that leads to an increased risk of fracture, usually due to mild trauma [1]. Although any fracture can be observed in clinical practice, with the exception of the skull bones, the most prevalent is the vertebral one and the most serious that of the proximal extremity of the femur [2], given its significant morbidity and mortality [3]. Genetic, anthropometric, nutritional and lifestyle factors [4,11] influence the appearance of fragility fractures or osteoporotic fractures, but also gynecological and obstetric factors [12]. Among them, breastfeeding reportedly exerts an essential reproductive function in women and protects the mother from developing many diseases, such as cancer or diabetes [11-14].

Survival for patients who suffer estrogen receptor positive (ER+) breast cancer has improved dramatically over the years due to the addition of adjuvant hormonal therapy, especially aromatase inhibitors (AI). Letrozole, anastrozole and exemestane are third generation AIs that massively reduce circulating estrogens in postmenopausal women. Although this effect is decisive for survival and the reduction of tumor relapse, it also leads to adverse events and quality of life problems, more prominently associated with the musculoskeletal system [1]. Its use in women as adjunctive treatment for 2-5 years has been correlated with an increased risk of bone loss and fractures [2,3]. Furthermore, AI administration is associated with the appearance and/or increase of arthralgia –described as joint pain– with an estimated incidence of 55% in a previous study by our group [4]. The high rate of arthralgias is of particular concern, since it is reportedly the most frequent reason for interrupting treatment [5,6]. Although practical guidelines have been developed to prevent and manage IA-related bone loss [7], effective treatment of arthralgia has yet to be addressed8.