Low intensity vibration with zoledronate reduces musculoskeletal weakness and adiposity in estrogen deprived female mice

Aromatase inhibitors are widely used in the treatment of hormone-sensitive breast cancer, but their suppression of estrogen production accelerates bone loss, increases fracture risk, and negatively impacts muscle and fat metabolism. Here, we demonstrate that daily low intensity vibration, serving as a non-drug mimetic for exercise, protects musculoskeletal health in skeletally immature, female mice under complete estrogen deprivation. Subsequent improvements in vertebral bone density are paralleled by greater and leaner skeletal muscle mass and function alongside reduced fat accretion and circulating metabolites. In mature, estrogen deprived mice, vibration enhances weekly bisphosphonate treatment, improving bone density, cortical thickness, and mechanical resistance to fracture. These findings support the proposed hypothesis that low intensity vibration reduces musculoskeletal frailty in estrogen deprived mice, with stronger effects observed in younger cohorts, while in skeletally mature mice combination therapy with anti-resorptive treatment is necessary to suppress cancer-treatment induced musculoskeletal degradation.