Contempo Updates
March 21, 2001

Treatment of Postmenopausal Osteoporosis

Author Affiliations

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.

JAMA. 2001;285(11):1415-1418. doi:10.1001/jama.285.11.1415

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 for osteoporosis.

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.

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