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

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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.

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Authors and Affiliations

  1. The Mount Sinai Bone Program, Mount Sinai School of Medicine, Box 1055, One Gustave Levy Place, New York, NY, 10029, USA

    Mone Zaidi

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  1. Mone Zaidi
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  2. Charles H. Turner
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  3. Ernesto Canalis
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  4. Roberto Pacifici
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  5. Li Sun
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  6. Jameel Iqbal
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  7. X. Edward Guo
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  8. Stuart Silverman
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  9. Solomon Epstein
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  10. Clifford J. Rosen
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Correspondence to Mone Zaidi.

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Zaidi, M., Turner, C.H., Canalis, E. et al. Bone loss or lost bone: Rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss. Curr Osteoporos Rep 7, 118–126 (2009). https://doi.org/10.1007/s11914-009-0021-4

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