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Bone loss or lost bone: Rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss

  • Mone Zaidi
  • , Charles H. Turner
  • , Ernesto Canalis
  • , Roberto Pacifici
  • , Li Sun
  • , Jameel Iqbal
  • , X. Edward Guo
  • , Stuart Silverman
  • , Solomon Epstein
  • , Clifford J. Rosen

Research output: Contribution to journalReview articlepeer-review

54 Scopus citations

Abstract

Recent reports suggest that bone loss begins during late perimenopause at a dramatic rate, even before estrogen levels plummet. During the ensuing 5 years, there is evidence of the beginnings of microarchitectural deterioration, which impacts bone strength and ultimately enhances its propensity to fracture. The diagnosis of osteoporosis based on T-scores alone, or through stratification for a high fracture risk by FRAX, excludes these women who are rapidly losing bone. Because all antiosteoporosis therapies, in particular bisphosphonates, reduce bone loss, we propose aggressive, likely short-term therapy with a goal to reduce bone loss, stabilize bone density, and prevent microarchitectural deterioration.

Original languageEnglish
Pages (from-to)118-126
Number of pages9
JournalCurrent Osteoporosis Reports
Volume7
Issue number4
DOIs
StatePublished - Dec 2009

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