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

Document Type


Publication Date



Bone-Density-Conservation-Agents, Bone-Remodeling, Female, Fractures-Spontaneous, Humans, Osteoporosis-Postmenopausal, Perimenopause, Risk-Assessment

JAX Location

see Reprint Collection (a pdf is available).

JAX Source

Curr Osteoporos Rep 2009 Dec; 7(4):118-26.


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.

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