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Fractures before menopause: a red flag for physicians.

W D Hosmer1, H K Genant, W S Browner

  • 1General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco & Department of Medicine, University of California, USA.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|May 28, 2002
PubMed
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Women with fractures before menopause face a higher risk of postmenopausal fractures. This premenopausal fracture history is an independent risk factor for future osteoporotic fractures, regardless of bone density.

Area of Science:

  • Gerontology
  • Epidemiology
  • Orthopedics

Background:

  • Early identification of women at risk for osteoporotic fractures is crucial for timely preventive interventions.
  • Understanding predictors of postmenopausal fractures can significantly improve patient outcomes and reduce healthcare burdens.

Purpose of the Study:

  • To investigate whether a history of fractures before menopause increases the risk of fractures after menopause.
  • To determine if premenopausal fractures are an independent risk factor for subsequent osteoporotic fractures.

Main Methods:

  • The Study of Osteoporotic Fractures cohort included 9086 ambulatory white women aged 65+.
  • Data collected included lifetime fracture history, bone mineral density, falls, maternal fracture history, and lifestyle factors.

Related Experiment Videos

  • Proportional hazards models were used to analyze the association between premenopausal fractures and postmenopausal fracture risk over 12 years.

    • Main Results:

    • Women with any premenopausal fracture had a significantly higher risk of fractures during the study period (HR, 1.33; 95% CI, 1.14-1.56).
    • This association remained significant even after adjusting for confounders like bone mineral density (HR, 1.25; 95% CI, 1.03-1.50).
    • Premenopausal fractures were identified as an independent risk factor, irrespective of estrogen use, fall history, or maternal fracture history.

    Conclusions:

    • A history of fractures before menopause is a significant, independent risk factor for fractures after menopause.
    • Assessing premenopausal fracture history is essential for identifying women at high risk for osteoporotic fractures.
    • Clinical decisions regarding preventive treatments should incorporate a comprehensive fracture history.