MORE THAN 1 million osteoporosis-related
fractures occur in the United States each year, resulting in estimated
total expenditures exceeding $13 billion.1,2 Osteoporotic
fractures, especially those of the hip, may be associated with a
decline in functional status and quality of life and decreased
survival.1 Both men and women lose bone at a rate of 0.3%
to 0.5% per year beginning in the fourth decade, but at menopause,
women experience accelerated bone loss at a rate of 3% to 5% per year
for 5 to 7 years.3 Weight-bearing exercise may retard bone
loss in postmenopausal women; since exercise also reduces the risk of
cardiovascular disease and may reduce falls, advising healthy
postmenopausal women to exercise is widely accepted. However, there is
more controversy about what medications or supplements should be
prescribed for osteoporosis prevention in healthy postmenopausal women.
In this article, we review recent evidence regarding the use of
calcium, vitamin D, estrogen, and bisphosphonates in the primary
prevention of postmenopausal osteoporosis.
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