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Related Experiment Videos

Premenopausal women and low bone density.

Aliya Khan1

  • 1Division of Endocrinology, McMaster University, Hamilton, Ont. avkhan@aol.com

Canadian Family Physician Medecin De Famille Canadien
|July 4, 2006
PubMed
Summary

Bone mineral density testing is not recommended for premenopausal women without specific indications. Low bone density in this group is often due to factors like low peak bone mass, not osteoporosis.

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Women's Health

Background:

  • Premenopausal women with low bone density present unique diagnostic and management challenges.
  • Distinguishing low peak bone mass from systemic disorders is crucial for appropriate care.

Purpose of the Study:

  • To review evidence on managing low bone density in premenopausal women.
  • To provide an evidence-based approach to diagnosis and treatment.

Main Methods:

  • Comprehensive literature search of MEDLINE (1990-2004).
  • Grading of evidence by level (I-III).
  • Recommendations based on randomized controlled trials and expert consensus.

Main Results:

  • Bone mineral density (BMD) testing should be reserved for specific indications in premenopausal women.
  • Screening for osteoporosis is not supported by current evidence in this population.
  • Low BMD in premenopausal women is associated with lower fracture risk compared to postmenopausal women, often reflecting low peak bone mass, lifestyle, or ovulatory disturbances.

Conclusions:

  • BMD alone is insufficient to diagnose osteoporosis in premenopausal women without fragility fractures.
  • Antiresorptive therapy may benefit premenopausal women on glucocorticoids or with primary hyperparathyroidism.

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