[Non-hormonal treatment of postmenopausal osteoporosis]

Non hormonal treatments for postmenopausal osteoporosis are curative and preventive treatments that do not call for sex hormones. Curative treatments aim to reduce the frequency of relapsing vertebral fractures and they mainly consist in sodium fluoride (50 mg/day) combined with Calcium (1 g element/day). Preventive treatments are intended to prevent the occurrence of vertebral fractures. They consist in calcium, physical exercise, vitamin D and calcitonin. Calcium and physical exercise are simple and inexpensive means which may be convenient for every woman, with no need for any preselection, and which can be combined together very well. They are however less effective than estrogen--progestogen combination. Vitamin D and its metabolites do not seem to be helpful for prevention of postmenopausal osteoporosis. Calcitonin is likely to offer good prospects for the future, because it has no major side effect and is able to restrain bone loss. Its use however will be dependent on a change in its mode of administration (intranasal), and a lowering of its cost (bacterial synthesis?). Lastly, a great effort has to be directed towards a thorough knowledge of osteoporosis risk factors, in order to carry out their elimination and the screening of high risk female patients.