Osteoporosis and menopause: What you should know…

• How common is osteoporosis?  Almost half of women older than 50 years will experience a fracture related to osteoporosis in their lifetimes.  These fractures often resulting in significant symptoms and impairment of function and quality of life.  Hip fractures may require surgery, a rehab stay or long-term nursing home.  Osteoporosis is substantially underdiagnosed and undertreated.  Ask your physician if a bone density (DEXA) test is right for you.
• Estrogen deficiency at menopause is the primary cause of bone loss leading to osteoporosis.
• Even with good nutrition and regular physical activity, osteoporosis progresses with advancing age unless treated.  There is no cure for osteoporosis so life-long management is required once the diagnosis has been made.
• Hormone therapy is the most appropriate choice to prevent bone loss at the time of menopause for healthy women, particularly those who have menopause symptoms.
• Bone mineral density measured while on treatment correlates with the patient’s current risk of fracture, providing justification for the use of the T-score at the hip as an appropriate clinical target. Therapy should be reviewed after each bone density test.
• Although antiremodeling drugs such as bisphosphonates and denosumab are the drugs chosen to treat most patients with osteoporosis, a new paradigm of beginning treatment with a bone-building agent, followed by an antiremodeling agent, is recommended for women at very high risk of fracture.  Talk to your doctor about what may be right for you.