Osteopenia—defined by a bone mineral density T-score between −1.0 and −2.5—is more common than osteoporosis and accounts for most fragility fractures in postmenopausal women. Approximately 50% of Korean women aged ≥ 50 years have osteopenia. Despite this high prevalence, optimal therapeutic strategies remain unclear. This review summarizes the clinical significance and management of osteopenia. Clinical practice often categorizes osteopenia into mild, moderate, and severe based on specific T-score ranges. Studies indicate that women transitioning from normal or moderate osteopenia to lower bone density experience more fractures. One study reported that approximately 10% of women with normal BMD or osteopenia progressed to osteoporosis, mostly from moderate to severe osteopenia groups. Fracture risks, particularly for hip and vertebral fractures, are elevated mainly in moderate to severe osteopenia.The National Osteoporosis Foundation and the American Association of Clinical Endocrinologists incorporate FRAX® scores alongside T-scores and clinical history to guide pharmacological intervention. Accordingly, South Korean guidelines classify fracture-risk groups as low, moderate, high, or very high, allowing treatment of patients with osteopenia in the high-risk categories. Evidence supporting medications for fracture prevention remains limited. However, growing interest in preventing fractures has directed the ongoing studies to evaluate various drugs. Food and Drug Administration-approved treatments include menopausal hormone therapy, bisphosphonates, and selective estrogen receptor modulators. To reduce fractures in postmenopausal women, treatment should not be restricted to osteoporosis alone. Women with moderate to severe osteopenia may also benefit from medications used for osteoporosis. Clinicians should assess individual fracture risks and select preventive treatments based on risk level, fracture site, menopausal symptoms, patient preference, and cost-effectiveness.

Since its introduction, laparoscopic surgery has been often preferred over open surgery in obstetrics and gynecology due to its advantages, such as less bleeding, lower incidence of adhesions, reduced postoperative pain, short hospital stay, and quick return to daily life. However, in the case of complex surgeries, laparoscopy presented some limitations. Nonetheless, since the 1980s, medical robots have been introduced to overcome the technical limitations of laparoscopy and start a new age for minimally invasive surgery. In this review, we explore the indications and advantages and disadvantages of robotic surgery in the field of gynecology, and try to assess the recent trend of robotic surgery.