Objective: To review osteoporosis, its pathophysiology, lifestyle and dietary factors that influence osteoporosis, and treatments to prevent and treat the disease in women.
Data sources: MEDLINE using the search term osteoporosis and individual therapies and interventions for 1974-1988.
Study selection: English-language studies in humans were reviewed. Prospective clinical trial data were selected when available; epidemiologic data were used when prospective clinical trials were not available.
Data synthesis: Pharmacists should initiate discussions with women of all ages to help prevent, recognize, and treat osteoporosis. Assessing and modifying calcium, vitamin D, caffeine, alcohol, and phosphate intake, increasing exercise, and minimizing falls can help prevent osteoporosis and fractures. The risks and benefits of hormone replacement therapy should be presented to women so they can make an informed decision. Hormone replacement therapy is the treatment of choice for preventing and treating osteoporosis; it also reduces cardiovascular morbidity and mortality. The benefits must be put into the proper perspective with adverse effects, events such as vaginal bleeding and the risk of breast cancer, that prevent women from taking estrogen. As not every woman is willing or able to take estrogen, alternatives should be discussed. Raloxifene prevents osteoporosis, has beneficial lipid effects, and does not stimulate breast or endometrial tissue. Alendronate is a safe and effective for the prevention and treatment of osteoporosis when administered properly. Calcitonin is approved for treatment of osteoporosis and provides analgesic effects for fractures.
Conclusion: Pharmacists should initiate discussions with women of all ages to help prevent, recognize, and treat osteoporosis. Assessing and modifying calcium and vitamin D, caffeine, alcohol, and phosphate intake, increasing exercise, and minimizing falls can help prevent osteoporosis and fractures.