Postmenopausal Osteoporosis

Abstract

Key Clinical Points Postmenopausal Osteoporosis Fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. Treatment is generally recommended in postmenopausal women who have a bone mineral density T score of -2.5 or less, a history of spine or hip fracture, or a Fracture Risk Assessment Tool (FRAX) score indicating increased fracture risk. Bisphosphonates (generic) and denosumab reduce the risk of hip, nonvertebral, and vertebral fractures; bisphosphonates are commonly used as first-line treatment in women who do not have contraindications. Teriparatide reduces the risk of nonvertebral and vertebral fractures. Osteonecrosis of the jaw and atypical femur fractures have been reported with treatment but are rare. The benefit-to-risk ratio for osteoporosis treatment is strongly positive for most women with osteoporosis. Because benefits are retained after discontinuation of alendronate or zoledronic acid, drug holidays after 5 years of alendronate therapy or 3 years of zoledronic acid therapy may be considered for patients at lower risk for fracture.

Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw

“…⑤ Given extremely low incidence of BRONJ in osteoporosis, the benefits of BP for fracture prevention outweigh the risks for BRONJ [35].…”

Interrelation Among Serum Lithium Levels and Bone Metabolism and Some Biochemical Parameters in Pre and Post-Menauposal Women

“…In osteoporosis, bones become sensitive due to decrease in bone mass caused by factors related with genetics, hormonal, environmental and diet and bone loss occurs in the endostal region of the skeleton [2]. One of the main reasons of osteoporosis is the deficiency in estrogen.…”

Osteoporosis and Joint Replacement

“…Basically, osteoporosis can occur at any age, but it increases in older people [1]. Due to the demographic development (especially, the increasing life expectancy in coming decades), this numbers are expected to increase in the future.…”