Diagnosis and Treatment of Osteoporosis

As the overall life span of both men and women increases, screening, diagnosis, and treatment of osteoporosis is of even greater importance than it has been in the past. It is estimated that more than 34 million Americans have low bone density, and 10 million suffer from osteoporosis.1 Approximately 80% of these people are women, the majority of whom are postmenopausal. The major morbidity and mortality that occur as a result of osteoporosis are secondary to long bone fractures. Hip fractures cause the greatest morbidity and mortality, and are associated with a 30% risk of mortality in the first year for men and 17% for women. Osteoporosis may also be associated with vertebral and forearm fractures, which can similarly affect quality of life and activities of daily living.2 There is a significant gap between the best-practice paradigm for the diagnosis and treatment of osteoporosis and actual clinical practice. The goal of this lesson is to help the obstetrician-gynecologist to better understand the pathophysiology of osteoporosis and to apply these principles to ensure appropriate screening, diagnosis, and treatment of patients at risk for this debilitating problem.