Osteoporosis (Postmenopausal)
Evaluation
General—a disease of skeletal weakness ranging from asymptomatic bone loss to fractures
Epidemiology—affects approximately 8 million American women
Risk factors
Elderly, white/Asian, family hx, small body frame, early menopause, prior oophorectomy
Modifiable—smoking, excess alcohol, lack of exercise, low calcium and vitamin D, low body weight
Medical comorbidities—hyperthyroidism, hyperparathy-roidism, and systemic corticosteroids
Diagnostic algorithm
Low bone mineral density on dual-energy x-ray absorptiometry (DEXA)
OR fragility fracture regardless of bone mineral density.
Classification (as per the World Health Organization) (see Table 2.43.1)
Management
Nonpharmacologic options
Reduce modifiable risk factors (avoid smoking, stop excessive alcohol, exercise, etc.)
Calcium supplementation (goal: intake 1,200-1,500 mg per day)
Vitamin D supplementation (deficient when serum 25-OH Vitamin D [25-hydroxyvitamin D] <A onclick="get_content(event,'AB1-M12'); return false;" onmouseover="window.status=this.title; return true;" onmouseout="window.status=''; return true;" title="<15 ng/mL)
Typically used for approximately 8 weeks to build vitamin D stores.
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