You can read the full text of this article if you:

Your message has been successfully sent to your colleague.

Address correspondence to: The North American Menopause Society, 30050 Chagrin Blvd, Suite 120W, Pepper Pike, OH 44124. E-mail: [email protected] ; Website: www.menopause.org

This position statement was developed by The North American Menopause Society (NAMS), with representatives of the NAMS Board of Trustees and other experts in women's health: Michael R. McClung, MD, FACP, FACE; JoAnn V. Pinkerton, MD, FACOG, NCMP; Jennifer Blake, MD; Felicia A. Cosman, MD; E. Michael Lewiecki, MD, FACP, FACE; and Marla Shapiro, MD, CM, CCFP, MHSc, FRCP(C), NCMP. The Board of Trustees conducted independent review and revision and approved the position statement on June 7, 2021.

This position statement was made possible by donations to the NAMS Education & Research Fund. There was no commercial support.

To review evidence regarding osteoporosis screening, prevention, diagnosis, and management in the past decade and update the position statement published by The North American Menopause Society (NAMS) in 2010 regarding the management of osteoporosis in postmenopausal women as new therapies and paradigms have become available.

NAMS enlisted a panel of clinician experts in the field of metabolic bone diseases and/or women's health to review and update the 2010 NAMS position statement and recommendations on the basis of new evidence and clinical judgement. The panel's recommendations were reviewed and approved by the NAMS Board of Trustees.

Osteoporosis, especially prevalent in older postmenopausal women, increases the risk of fractures that can be associated with significant morbidity and mortality. Postmenopausal bone loss, related to estrogen deficiency, is the primary contributor to osteoporosis. Other important risk factors for postmenopausal osteoporosis include advanced age, genetics, smoking, thinness, and many diseases and drugs that impair bone health. An evaluation of these risk factors to identify candidates for osteoporosis screening and recommending nonpharmacologic measures such as good nutrition (especially adequate intake of protein, calcium, and vitamin D ), regular physical activity, and avoiding smoking and excessive alcohol consumption are appropriate for all postmenopausal women. For women at high risk for osteoporosis, especially perimenopausal women with low bone density and other risk factors, estrogen or other therapies are available to prevent bone loss. For women with osteoporosis and/or other risk factors for fracture, including advanced age and previous fractures, the primary goal of therapy is to prevent new fractures. This is accomplished by combining nonpharmacologic measures, drugs to increase bone density and to improve bone strength, and strategies to reduce fall risk. If pharmacologic therapy is indicated, government-approved options include estrogen agonists/antagonists, bisphosphonates, RANK ligand inhibitors, parathyroid hormone-receptor agonists, and inhibitors of sclerostin.

Osteoporosis is a common disorder in postmenopausal women. Management of skeletal health in postmenopausal women involves assessing risk factors for fracture, reducing modifiable risk factors through dietary and lifestyle changes, and the use of pharmacologic therapy for patients at significant risk of osteoporosis or fracture. For women with osteoporosis, lifelong management is necessary. Treatment decisions occur continuously over the lifespan of a postmenopausal woman. Decisions must be individualized and should include the patient in the process of shared decision-making.

Your message has been successfully sent to your colleague.

Your message has been successfully sent to your colleague.

Keywords Bisphosphonates , Bone mineral density , Calcium , Estrogen agonists/antagonists , Falls , Fractures , Osteoporosis , Parathyroid hormone-receptor agonists , Postmenopause , Prevention , RANK ligand inhibitors , Vitamin D

Search for Similar Articles You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

This website uses cookies. By continuing to use this website you are giving consent to cookies being used. For information on cookies and how you can disable them visit our Privacy and Cookie Policy.