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Postmenopausal Osteoporosis

Key Points

• The management of postmenopausal osteoporosis involves an individualised regimen of dietary intervention (calcium, vitamin D), lifestyle modification (exercise, avoidance of falls), and, if necessary, pharmacological therapy.
  
  
• Oestrogen is the drug of choice (prevention + treatment), although the potential benefits (skeleton, heart) must be balanced against the possible risks (cancer).
  
  
• Because not every women is willing or able to take oestrogen or HRT, other therapies are needed; calcitonin (treatment), alendronate (prevention + treatment) and raloxifene (prevention) are safe and effective alternatives.
  
  
• Active vitamin D metabolites may be of benefit in some women, although their place in the treatment of postmenopausal osteoporosis remains unclear.

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