Causes of osteoporosis include increasing age, female sex. Here, learn about prevention, symptoms, treatments, and more. It is the policy of nof to ensure balance, independence, objectivity and scientific rigor in all sponsored. Type ii osteoporosis senile osteoporosis typically happens after age 70 and involves a thinning of both the. The relationship between postmenopausal osteoporosis and. Epidemiology and financial burden of osteoporosis with advancing age, bmd decreases and prevalence of osteoporosis increases.
Definition of osteoporosis a disease characterized by. Hip and spine fractures are associated with particularly high morbidity and mortality in this population. In postmenopausal women, risk factors for this fracture are advancing age, an. The conceptual definition of osteoporosis links the high risk of. The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as early as 1941 by albright and colleagues. Prevention and treatment of postmenopausal osteoporosis sunna kwun md,a marc j laufgraben md mba face facp,b geetha gopalakrishnan md c, aendocrine fellow, division of endocrinology, alpert medical school of brown university, hallett center for diabetes and endocrinology, 900 warren ave, east providence, ri 02914, usa bdivision head, division of endocrinology, diabetes, and metabolism. Menopause, perimenopause and postmenopause are stages in a womans life when her monthly period stops.
Prevention and treatment of postmenopausal osteoporosis. Chen, 2015 pharmacologic treatment icsi work group consensus recommendation bisphosphonates should be considered in postmenopausal women and men with osteopenia and increased fracture risk as well as patients with glucocorticoidinduced osteoporosis. The majority of osteoporosis cases seen by the medical community take the form of postmenopausal osteoporosis. Over time, bone mass, and therefore bone strength, is decreased. These guidelines were developed by the american association of clinical endocrinologists aace with hopes of reducing the risk of osteoporosisrelated fractures and thereby maintaining the quality. The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as early as 1941. These guidelines were developed by the american association of clinical endocrinologists aace with hopes of reducing the risk. Osteoporosis is a growing major public health problem with impacts on quality and quantity of life that cross medical, social, and economic lines. There may be 2 causes of postmenopausal osteoporosis. Osteoporosis is a metabolic bone disorder that is characterized by low bone mass and microarchitectural deterioration of bone tissue. Pathophysiology of postmenopausal osteoporosis springerlink.
A 60yearold women has a 44% risk of fracture while a. Postmenopausal osteoporosis definition of postmenopausal. Health care guideline diagnosis and treatment of osteoporosis. Treatment of postmenopausal osteoporosis pierre d delmas osteoporosis iv 2018 the lancet vol 359 june 8, 2002. Pathophysiology of postmenopausal osteoporosis there may be 2 causes of postmenopausal osteoporosis a. Bone is living tissue that is constantly being broken down and replaced. Alendronate, risedronate, and raloxifene are also approved for the prevention of postmenopausal osteoporosis, as well as various estrogen premarin, alora, climara and. These guidelines were developed by the american association of clinical endocrinologists aace with hopes of reducing the risk of osteoporosisrelated fractures and thereby maintaining the quality of life for people with osteoporosis. What causes postmenopausal and senile osteoporosis. Osteoporosis definition the word osteoporosis literally means porous bones. Ibandronate boniva is another oral fdaapproved for prevention and treatment of postmenopausal osteoporosis and intravenous iv fdaapproved for treatment of postmenopausal osteoporosis bp preparation, which is dosed at monthly intervals orally 150 mg and 3. Osteoporosis, which is especially prevalent among older postmenopausal women, increases the risk of fractures.
Remaining causative factors for the peak bone mass include factors like nutrition, activity and hormonal interplay. The who definition applies to postmenopausal women and men aged 50 years or older. Osteoporosis causes bones to become weak and brittle so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture. The aim of treatment of postmenopausal osteoporosis is to reduce the frequency of vertebral and nonvertebral fractures especially at the hip, which are responsible for morbidity associated with the disease. The guide also addresses secondary causes of osteoporosis which should be excluded by clinical.
Perimenopause is the first stage in this process and can start eight to 10 years before menopause. Ways to prevent and treat postmenopausal osteoporosis. Postmenopausal women have a higher rate of osteoporosis and fractures than older men. The guide addresses postmenopausal women and men age 50 and older. Guidelines american association of clinical endocrinologists. The initial evaluation includes a history to assess for clinical risk factors for fracture and to evaluate for other conditions that contribute to bone loss, a physical examination, and basic laboratory tests. Effect of 1,25dihydroxyvitamin d3 in itself or combined with hormone treatment in preventing postmenopausal osteoporosis. Even a sneeze or a sudden movement may be enough to. Menopause is the point when a woman no longer has menstrual periods for at least 12 months. Increased bone loss, or both peak bone mass is determined 70%80% by genetic factors 58. Significant mortality and morbidity are associated with osteoporotic fractures. This form of osteoporosis cannot be entirely prevented, but there are some steps which women can take to reduce the severity of bone loss after menopause, and to care.
Epidemiology and diagnosis of postmenopausal osteoporosis. In a threeyear analysis of the two largest prevention trials, 1,145 postmenopausal women 60 years or younger and an average of 5 years postmenopausal without osteoporosis were randomly assigned to raloxifene versus placebo. All groups received 400 to 600 mg of elemental calcium. Prevention and treatment of osteoporosis in postmenopausal. Although these definitions are necessary to establish the prevalence of. In the united states, europe and japan, osteoporosis affects about 75 million people 2. Osteoporosis is a very common disorder, which results in an increase in fracture risk. Osteoporosis is most common in women after menopause, but anyone can develop it. Osteoporosis is a condition that can be prevented or postponed by following certain healthy lifestyle habits and behaviors. A 63yearold woman presents with a history of acute low back pain. National osteoporosis foundation clinicians guide to prevention and treatment of osteoporosis developed by the national osteoporosis foundation nof in collaboration with. These changes lead to bone loss, usually in the trabecular spongy bone inside the hard cortical bone.
Osteoporosis meaning porous bones characterized by low bone mass and structural deterioration of bone tissue. Postmenopausal osteoporosis ontario osteoporosis strategy. Recommendations for osteoporosis screening with dexa scan. Evaluation for secondary osteoporosis primary osteoporosis is related to aging and loss of gonadal function. In view of growing awareness of the need to prevent and treat postmenopausal osteoporosis, the book aims to resolve several controversies concerning the usefulness of screening programmes, the appropriate target populations, the most effective methods for predicting fracture risk, techniques for assessment, and the comparative effectiveness of.
Osteoporosis is a classical agerelated disease that affects women more often than men. As a result, bones become fragile and break easily. The exact mechanisms of this steroid hormone deficiency in postmenopausal women as well as in the elderly men are continuously being unraveled. Given the health implications of osteoporotic fractures, the primary goal of osteoporosis therapy is to prevent. The method that is most widely used for the diagnosis of osteoporosis is dual energy x ray absorptiometry. Postmenopausal women have decreased estrogen which contributes to their higher rates of osteoporosis. Deficient calcitonin response to calcium stimulation in postmenopausal osteoporosis. Postmenopausal osteoporosis fact sheet overview osteoporosis, meaning porous bone, is a disease characterized by weak bones and is caused by excessive bone loss. To determine the effects of etidronate a bisphosphonate that inhibits osteoclastmediated bone resorption in the treatment of postmenopausal osteoporosis, we conducted a prospective, twoyear. Management of postmenopausal osteoporosis includes nonpharmacologic treatment e.
It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Osteoporosisrelated fractures most commonly occur in the hip, wrist or spine. No every 210 years depending on initial tscore no upper age limit. Postmenopausal osteoporosis is a form of osteoporosis which occurs in women after menopause. The conceptual definition of osteoporosis links the high risk of postmenopausal fractures to low bmd and qualitative changes in microarchitec.
Radiographic findings suggestive of osteopenia and osteoporosis are frequently encountered in everyday medical practice and can result from a wide spectrum of diseases ranging from highly prevalent causes such as senile and postmenopausal osteoporosis to endocrinologic and rare hereditary or. Postmenopausal women under 65 years withat least one of the following. A total of 8 electronic databases were searched to identify studies that included the following keywords. Clinicians guide to prevention and treatment of osteoporosis. Using the who criteria, 30% of postmenopausal caucasian women have osteoporosis at the hip, lumbar spine or distal forearm 3. In the beginning, that is from the 1960s, when a link between menopause and osteoporosis was first identified.
Assessment of fracture risk and its application to. The personal and economic burden of postmenopausal osteoporosis results from osteoporotic fractures, which are a significant public health problem, resulting in substantial morbidity and mortality. Fractures of the proximal femur, the vertebrae and the distal radius are the most frequent osteoporotic fractures, although most fractures in the elderly are probably at least partly related to bone fragility. The majority of postmenopausal women with osteoporosis have bone loss related to estrogen deficiency andor age. Postmenopausal osteoporosis article about postmenopausal. The views of bone experts on the assessment and treatment of. She had menopause at 44 years of age but never received. Secondary osteoporosis is caused by other health conditions table 4.