Abstract:
Peak bone mass for spine and hip is reached in the mid-twenties and adolescents should be counselled on adequate
nutrition to ensure sufficient calcium intake, regular weight-bearing exercise, maintaining normal body weight, avoiding
smoking and limiting alcohol intake. These measures are important to prevent osteopenia and osteoporosis by obtaining a
maximum peak bone mineral density (BMD) and to maintain it by avoiding excessive bone loss. One year before the onset of
menopause, however, as a result of oestrogen deficiency, there is an increase in osteoclastic activity without a similar increase
in osteoblastic activity, resulting in accelerated bone loss. The average decrease in BMD during the menopausal transition
is estimated to be about 10% and a woman’s risk of sustaining an osteoporotic or fragility fracture doubles for each decade
after the age of fifty. Half of women older than 50 years of age will be osteopenic compared to 10% who are osteoporotic and
only 40% will have normal BMD. This article gives an overview of the prevention, diagnosis and management of osteoporosis
during and before menopause.
