Chemical and pharmacologic treatment of osteoporosis

HRT, analogue medications, and different therapeutic approaches for the prevention and treatment of postmenopausal osteoporosis have been discussed. Although exact treatment regimens have yet to be established, the literature is generally unconditionally supportive of HRT in postmenopausal women for preventing and treating osteoporosis, reducing the incidence of cardiovascular disease and morbidity, and improving the quality of life throughout an extended life span. Information and counseling about the benefits and risks associated with HRT should be afforded every postmenopausal woman, and she should participate in all decisions about the treatment regimen prescribed. Older age predisposes a woman to the carcinogenic potential of estrogen, but this must be placed in perspective for every patient owing to the overwhelming positive benefits gained from HRT in improving the overall quality of life. The decision to initiate or continue HRT in women over age 60 must be made by each individual and her physician with consideration given to the potential risks. The fear of developing breast cancer as a result of HRT is widespread among physicians and patients; however, there is no research that has identified a cause-and- effect relationship in women users without a documented risk for cancer. In women with an intact uterus who have developed endometrial cancer, their individual treatment regimens and their lack of compliance with HRT were highly suspect. Continued use of HRT in elderly women has the potential for enhancing the quality of life for the woman and her family. The incidence of injury, disability, dysfunction, loss of independence, morbidity, and mortality attributed to osteoporotic events increases exponentially with age. The economic consequences are proportional to the prevalence and incidence of osteoporosis and can be expected to increase as the number of elderly men and women increases. Preventing osteoporotic fractures reduces health care costs, hospitalizations, and morbidity. Reducing or preventing the rapid rise in cardiovascular disease in postmenopausal women can yield similar favorable social and economical effects. Healthy women can remain independent into their later years, delaying the necessity for assistance, which is financially and psychologically burdensome for their families.

Duke Scholars

Author Corrie Jane Odom Orthopaedic Surgery, Physical Therapy