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Contempo 1998 |

Primary Prevention of Postmenopausal Osteoporosis

Wendy Levinson, MD; Diane Altkorn, MD
JAMA. 1998;280(21):1821-1822. doi:10.1001/jama.280.21.1821.
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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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