Approach to premenopausal osteoporosis.
Khushboo Agarwal1, Lakshmi Nagendra2, Saptarshi Bhattacharya3
1Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore.
Current Opinion in Endocrinology, Diabetes, and Obesity
|October 12, 2025
Summary
Premenopausal osteoporosis requires early identification and intervention to mitigate long-term skeletal risks. Management involves optimizing bone health and addressing secondary causes, with limited evidence for pharmacological treatments.
Area of Science:
- Endocrinology
- Bone Metabolism
- Women's Health
Background:
- Premenopausal osteoporosis is uncommon but carries significant long-term skeletal risks.
- Unlike postmenopausal osteoporosis, causes include inadequate peak bone mass or secondary factors like disease, medications, or lifestyle.
- This review focuses on current strategies for defining, diagnosing, and managing low bone mass and osteoporosis in premenopausal women.
Purpose of the Study:
- To explore contemporary approaches to defining, diagnosing, and treating low bone mass and osteoporosis in premenopausal women.
- To highlight the unique aspects of premenopausal osteoporosis compared to postmenopausal osteoporosis.
Main Methods:
- Literature review of contemporary approaches.
- Analysis of factors influencing peak bone mass.
- Evaluation of diagnostic tools and management strategies.
Main Results:
- Prevalence varies by ethnicity, with higher risks in Caucasian and Asian women.
- Genetics, nutrition, lifestyle, and occupational exposures are key determinants of peak bone mass.
- Dual-energy X-ray absorptiometry is the gold standard for diagnosis, though emerging technologies show promise.
- Management includes nutrition, exercise, addressing secondary causes, and cautious consideration of bisphosphonates or teriparatide in high-risk cases.
Conclusions:
- Early identification and intervention are crucial for reducing fracture risk in premenopausal women.
- Improved diagnostic tools and individualized treatment strategies are needed.
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