Author/Editor		Kocijančič, A
Title		Pomenopavzalna osteoporoza
Translated title		Postmenopausal osteoporosis
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 63, št. 10
Publication year		1994
Volume		str. 595-602
Language		slo
Abstract		Background. Postmenopausal osteoporosis in a condition characterized by a reduction in bone mineral density by more than two standard deviations below the mean for normal young adults. In postmenopausal women the loss of sex steroids leads to increased skeletal remodeling with excessive osteoclast activity. The bone loss that precedes the osteoporotic fracture syndrome is a symptomless process. Low bone mass can be readily detected by non-invasive absorptiometric techniques. Conclusions. Estrogen therapy instituted soon after menopause slows or even reverses the loss of bone and thus protects women against later vertebral and hip fractures. For long-term preservation of bone mineral density women should take estrogen for at least ten years after menopause. If the patient still has her uterus progestagen should be added to avoid the risk of endometrial cancer. For those patients who cannot or should not take estrogens alternative drugs are calcitonin or biphosphonates, which have similar effects as estrogens. Both inhibit bone resorption, yet the reduction in bone loss is not accompanied by lower risk of fractures. Resistance to calcitonin and biphosphonates may develop after one or two years of therapy. Sodium, fluoride has been shown to increase spinal bone mass in a dose- dependant manner, but has never been convincingly demonstrated to reduce the vertebral fracture rate in patients with established spinal osteoporosis. The preventive strategies include also regular exercise, and avoidance of cigarettes and alcohol. All postmenopausal women should be given sufficient calcium to bring the total intake to 1500 mg/day.
Descriptors		OSTEOPOROSIS, POSTMENOPAUSAL ESTROGEN REPLACEMENT THERAPY BONE DENSITY