Author Affiliations: Sections of General Internal Medicine (Dr Altkorn) and Endocrinology (Dr Vokes), Department of Medicine, University of Chicago, Chicago, Ill.
Contempo Updates Section Editor: Alice T. D. Hughes, MD, Fishbein Fellow.
Postmenopausal osteoporosis is a common and serious clinical problem.
As both individuals and society have come to recognize the importance of preventing
and treating osteoporosis, several new medications have been developed that
have been shown to reduce fracture rates in women with osteoporosis. This
article will review recent studies and evaluate the currently available treatments
All women with low bone mineral density (BMD) should ingest 1200 to
1500 mg of calcium and 400 to 800 IU of vitamin D daily.1
The National Osteoporosis Foundation recommends pharmacological treatment
of all postmenopausal women with T scores (the number of SDs below peak young
adult bone mass) below −2.0, and those with T scores below −1.5
and risk factors for osteoporosis.1 However,
for the same level of BMD, the fracture risk is much greater in older than
in younger subjects.2 Furthermore, the greatest
benefit in fracture reduction occurs in patients with preexisting vertebral
fractures or T scores below −2.5.3 While
older women with low BMD and a history of an osteoporotic fracture should
be treated pharmacologically, the decision is less clear for other patients.
Altkorn D, Vokes T. Treatment of Postmenopausal Osteoporosis. JAMA. 2001;285(11):1415-1418. doi:10.1001/jama.285.11.1415