Citation

Prescrire Int. 1998; 7(37): 155-159.

Copyright

(Copyright © 1998, Association Mieux Prescrire)

DOI

unavailable

PMID

10915424

Abstract

(1) Osteoporosis is one of several recognized causes of bone weakness in elderly women, and accounts for the high incidence of fractures. Hip fracture carries the highest rates of morbidity and mortality. (2) Bone density measurement in a given woman is not predictive of her individual risk of fracture. None of the recommendations we examined propose routine screening for osteoporosis by bone density measurement in all postmenopausal women. (3) Women at risk should be identified, so that they can benefit from detection and prevention. Detection is mainly based on clinical evidence. (4) Whatever the age and period of life, prevention of osteoporotic fractures in women is based on adequate supply of calcium (at least 1 g/day, mainly in the diet) and vitamin D, and on regular physical exercise and fall prevention. (5) Oestrogen therapy is the first-line drug-based prevention of osteoporotic fractures, despite worries about possible carcinogenicity. (6) Routine hormone replacement therapy for all women, starting at menopause, is not recommended. The decision should be made individually. (7) Before starting treatment, patients should be informed of the need for long-term compliance. (8) Consensus statements recommend hormone replacement therapy as secondary prevention for women having already had osteoporotic fractures, and as primary prevention for women at risk.

Language: en