A rationale for the current management of post-menopausal osteoporosis

Because of the potential impact on so many of our patients of post-menopausal osteoporosis, and the staggering costs the disease imposes on our health-care system, it behooves all family doctors to maintain an up-to-date approach to its management, including prevention as well as treatment. In a brief review of some aspects of bone metabolism, the author attempts to clarify why osteoporosis develops in post-menopausal women and to relate these causes to principles of management. He presents current experimental evidence in support of specific modalities (e.g., supplemental estrogen), and considers the relative risks of using these modalities. Finally, he raises a number of practical issues relating to the application of such routines into practice.