Bone loss or lost bone: rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss.
Bone-Density-Conservation-Agents, Bone-Remodeling, Female, Fractures-Spontaneous, Humans, Osteoporosis-Postmenopausal, Perimenopause, Risk-Assessment
see Reprint Collection (a pdf is available).
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.
Zaidi, M; Turner, C H.; Canalis, E; Pacifici, R; Sun, L; Iqbal, J; Guo, X E.; Silverman, S; Epstein, S; and Rosen, C J., "Bone loss or lost bone: rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss." (2009). Faculty Research 2000 - 2009. 2091.