to induce the transdifferentiation of pro-inflammatory M1 macrophages into osteoclasts and increase the ratio of M1 to anti-inflammatory M2 macrophages . Without estrogen, more dendritic cells were shown to express IL-7 and IL-15, which upregulates IL-17 and TNF-α production by T cells . Furthermore, a cross-sectional clinical study of postmenopausal women showed that elevated inflammatory markers such as IL-6, IL-β, and TNF-α were negatively correlated with bone mass . These findings indicate estrogen regulates bone remodeling through immune-mediated effects and direct signaling within the bone microenvironment.