To date, we have not had significant pool of women who:
2. have a significant diving experience including appropriate number of dives at profound depth which put them at risk for osteonecrosis
Therefore, we have no data on coincident osteoporosis and osteonecrosis in women at risk (or men for that matter).
Fitness and Diving Issue
The pathophysiologic mechanisms leading to osteoporosis and osteonecrosis are different. Osteoporosis results from decreases in osteoblast activity and relative increase of osteoclast activity, resulting in bone resorption and demineralization. The infarction of the microcirculation of bone is the triggering mechanism for osteonecrosis.
Women are at increased risk for osteoporosis given that their overall lifetime peak bone mass is lower than men and that the loss of estrogen during menopause, greatly accelerates the rate of bone demineralization.
All we can say at this point is that women should dive as conservatively as possible, thereby trying to minimize their risks of osteonecrosis, so as not to impose this bone damaging disease on top of their already increased risk of fracture due to Type I estrogen dependent osteoporosis.