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Osteoporosis risk in premenopausal women.
Pharmacotherapy. 2009 Mar; 29(3):305-17.P

Abstract

Although clinically significant bone loss and fractures in healthy premenopausal women are rare, more women are seeking evaluation for osteoporosis from their health care providers. As pharmacists are in an ideal position to influence the management of premenopausal women with osteoporosis, it is important that pharmacists understand the available data on bone loss, fractures, and risk factors and secondary causes for osteoporosis, as well as when to recommend testing and treatment in premenopausal women. Limited data are available; therefore, we conducted a MEDLINE search of the literature from January 1993-August 2008. Studies evaluating bone loss, fractures, and fracture risk in healthy premenopausal women were targeted and summarized; most recommendations are based on expert opinion. A small but statistically significant loss in bone mineral density of 0.25-1%/year by dual-energy x-ray absorptiometry is seen healthy premenopausal women; the clinical significance of this is unknown. Whereas absolute fracture risk is low, premenopausal fractures appear to increase postmenopausal fracture risk by 1.5-3-fold. Risk factors for low bone density appear to be similar between pre- and postmenopausal women. Bone density screening in healthy premenopausal women is not recommended, but bone mineral density testing is advisable for those who have conditions or who receive drug therapy that may cause secondary bone loss. Lifestyle modification emphasizing bone-healthy habits such as adequate calcium and vitamin D nutrition, regular exercise, limitation of caffeine and alcohol consumption, and avoidance of tobacco are essential to the management of osteoporosis risk. The efficacy and safety of osteoporosis drugs have not been adequately demonstrated in premenopausal women. Therefore, pharmacologic interventions cannot be recommended in young women with low bone mass but may be considered in those having a more significant fracture risk, such as those with a previous low-trauma fracture or an identified secondary cause for bone loss.

Authors+Show Affiliations

Department of Clinical Pharmacy, School of Pharmacy, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado 80045, USA. sheryl.vondracek@ucdenver.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19249949

Citation

Vondracek, Sheryl F., et al. "Osteoporosis Risk in Premenopausal Women." Pharmacotherapy, vol. 29, no. 3, 2009, pp. 305-17.
Vondracek SF, Hansen LB, McDermott MT. Osteoporosis risk in premenopausal women. Pharmacotherapy. 2009;29(3):305-17.
Vondracek, S. F., Hansen, L. B., & McDermott, M. T. (2009). Osteoporosis risk in premenopausal women. Pharmacotherapy, 29(3), 305-17. https://doi.org/10.1592/phco.29.3.305
Vondracek SF, Hansen LB, McDermott MT. Osteoporosis Risk in Premenopausal Women. Pharmacotherapy. 2009;29(3):305-17. PubMed PMID: 19249949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Osteoporosis risk in premenopausal women. AU - Vondracek,Sheryl F, AU - Hansen,Laura B, AU - McDermott,Michael T, PY - 2009/3/3/entrez PY - 2009/3/3/pubmed PY - 2009/4/21/medline SP - 305 EP - 17 JF - Pharmacotherapy JO - Pharmacotherapy VL - 29 IS - 3 N2 - Although clinically significant bone loss and fractures in healthy premenopausal women are rare, more women are seeking evaluation for osteoporosis from their health care providers. As pharmacists are in an ideal position to influence the management of premenopausal women with osteoporosis, it is important that pharmacists understand the available data on bone loss, fractures, and risk factors and secondary causes for osteoporosis, as well as when to recommend testing and treatment in premenopausal women. Limited data are available; therefore, we conducted a MEDLINE search of the literature from January 1993-August 2008. Studies evaluating bone loss, fractures, and fracture risk in healthy premenopausal women were targeted and summarized; most recommendations are based on expert opinion. A small but statistically significant loss in bone mineral density of 0.25-1%/year by dual-energy x-ray absorptiometry is seen healthy premenopausal women; the clinical significance of this is unknown. Whereas absolute fracture risk is low, premenopausal fractures appear to increase postmenopausal fracture risk by 1.5-3-fold. Risk factors for low bone density appear to be similar between pre- and postmenopausal women. Bone density screening in healthy premenopausal women is not recommended, but bone mineral density testing is advisable for those who have conditions or who receive drug therapy that may cause secondary bone loss. Lifestyle modification emphasizing bone-healthy habits such as adequate calcium and vitamin D nutrition, regular exercise, limitation of caffeine and alcohol consumption, and avoidance of tobacco are essential to the management of osteoporosis risk. The efficacy and safety of osteoporosis drugs have not been adequately demonstrated in premenopausal women. Therefore, pharmacologic interventions cannot be recommended in young women with low bone mass but may be considered in those having a more significant fracture risk, such as those with a previous low-trauma fracture or an identified secondary cause for bone loss. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/19249949/Osteoporosis_risk_in_premenopausal_women_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=19249949.ui DB - PRIME DP - Unbound Medicine ER -