Osteoporosis: alternatives to estrogen treatment

Osteoporosis-related fractures result in significant morbidity, mortality, and cost in the United States. With the aging of our population, the cost to society and number of individuals who will become disabled by hip fractures alone could triple by the year 2040. Many known risk factors allow us to identify individuals with increased susceptibility for osteoporosis. Secondary causes of bone loss should always rigorously be ruled out in patients. Laboratory assessment and measurement of bone mineral density can help aid treatment choices. This article discusses risk factors for and secondary causes of osteoporosis, as well as radiographic and laboratory evaluation for the disease. It also presents nonestrogen treatments for osteoporosis. Lifestyle changes are an important aspect of treatment. In addition, antiresorptive and anabolic agents can markedly improve bone mineral density. Our ability to prevent fractures will be improved in the future as we are better able to assess fracture risk, measure bone strength, and provide new compounds for the prevention and treatment of bone loss.