Menopause and osteoporosis: Non-pharmacological and pharmacological management

Once osteoporosis has been identified, risk stratification is followed by non- pharmacological and, where needed, pharmacological management, which may include menopausal hormone therapy (MHT) where indicated.

This article will build on general practitioners' skills in stratifying fracture risk, supporting their patients to maintain bone health and preventing osteoporotic fracture by instigating lifestyle changes along with appropriate pharmacotherapy.

Risk stratification entails integrating fracture history, bone density and FRAX risk into The Royal Australian College of General Practitioners' official modified flowchart. Non-pharmacological treatments, such as ensuring adequate calcium intake and vitamin D sufficiency, form the basis of bone health maintenance. MHT should be considered in women aged <65 years with T-scores between -1.8 and -2.5. Pharmacotherapy is integral to fracture prevention in osteoporosis. Those at very high fracture risk may need a referral to a consultant physician for consideration of bone anabolic therapy.