Variations in treatment of postmenopausal osteoporosis

The purpose of this study was to determine trends and differences between various medical specialties with regard to the treatment of postmenopausal osteoporosis. The method used was a cross-sectional survey, and the authors' sample was composed of 116 physicians. There was an overall lack of consensus on choice of treatment for postmenopausal osteoporosis. Treatment varies with the individual physician without any strict adherence to a formal therapeutic protocol. Calcium was the treatment modality most widely used by all the specialties. Gynecologists and endocrinologists show the greatest usage of estrogens, while orthopedic surgeons show the least. Fluoride was used significantly less than calcium, vitamin D, estrogen, diet, and exercise by all the specialties surveyed. One in three postmenopausal women in the United States has osteoporosis, and one in five will sustain a hip or vertebral fracture. Twelve to twenty percent of elderly patients die within six months of sustaining a hip fracture. There is an obvious need for carefully constructed clinical programs evaluating multiple agents and diagnostic techniques.