[Postmenopausal osteoporosis: risk factors and possible therapies]

Risk factors for osteoporosis and the therapies (including those still being validated) utilisable in the primary and secondary management of patients with declared osteoporosis or those at risk of the disease are reviewed. The role of oestrogens in the pathogenesis of postmenopausal osteoporosis is well documented and replacement hormonal therapy prevents the rapid bone loss that accompanies the menopause, albeit with the well-known limitations. A valid alternative would seem to be provided by a diet rich in phyto-oestrogens which as they are natural SERMs, are able to produce effects similar to the oestrogens. The drugs of the new generation are also taking on an increasingly important role in the treatment of postmenopausal osteoporosis, although it is reasonable to think that in order to define them as effective and innocuous it will be necessary to await the conclusion of ongoing trials and an adequate number of years.