Postmenopausal osteoporosis: Etiology, current diagnostic strategies, and nonprescription interventions

OBJECTIVE: To describe the etiology, diagnosis, and nonprescription interventions for the prevention and treatment of postmenopausal osteoporosis. BACKGROUND: Osteoporosis affects more than 20 million individuals in North America and is responsible for more than 1.5 million fractures in the United States. About 50% of white women in the United States will have an osteoporotic fracture during their lifetime. SUMMARY: Postmenopausal osteoporosis is the result of estrogen deficiency, which results in up-regulation of several cytokines and excessive bone resorption. Various bone mineral density (BMD) testing methods are available, but the World Health Organization based the diagnosis of postmenopausal osteoporosis on the presence of a BMD T-score that is 2.5 standard deviations or greater below the mean for young women as assessed by dual-energy X-ray absorptiometry (DXA) at the hip, spine, and midradius. Ensuring adequate calcium and vitamin D intake is the cornerstone of any regimen aimed at preventing or treating postmenopausal osteoporosis. Other nonpharmacologic measures address modifiable risk factors for the disease and include exercise, smoking cessation, reducing consumption of caffeine and alcohol, and avoiding medications known to decrease bone mass. CONCLUSIONS: Postmenopausal osteoporosis is the result of estrogen deficiency and excessive bone resorption. Ensuring intake combined with lifestyle changes to address modifiable risk factors for the disease may help in the prevention and treatment of this condition.