The menopause and HRT. Prevention and management of osteoporosis.
Post-menopausal osteoporosis is characterized by increased fracture risk due to deficiencies in both the quantity and quality of bone. Assessing fracture risk involves combining clinical risk factors, including fall risks, with bone density testing. Treatment strategies are aimed at reducing fracture risk. General nutritional and lifestyle measures are appropriate for all women. Drug treatment is most clearly indicated in post-menopausal women at high current fracture risk. Treatment should also be considered for women at intermediate fracture risk, including those who have both low bone density and other risk factors for fracture. Whether there is practical clinical value in treating low-risk patients is much less clear. Non-pharmacological approaches addressing the consequences of fractures are integral parts of a comprehensive treatment programme. Reducing both the frequency and the effects of falls complements the efforts of treating osteoporosis to reduce the incidence of fractures and their important clinical consequences.
McClung
Michael R
MR
Oregon Osteoporosis Center, 5050 NE Hoyt Street, Suite 651, Portland, OR 97210, USA. mmcclung@orost.com
D002116:Calcitonin / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000517:prevention & control*; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use
D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D014807:Vitamin D; D002116:Calcitonin; D002118:Calcium