ACOG educational bulletin. Osteoporosis. Number 246, April 1998 (replaces No. 167, May 1992). American College of Obstetricians and Gynecologists.

Advances in imaging technology allow clinicians to diagnose osteoporosis before a clinically significant fracture occurs. In addition, advances in pharmacology give clinicians a broad range of estrogens and nonestrogen treatments for osteoporosis. These advances in imaging technology and treatment are timely. As the population ages, a large increase in osteoporotic fractures is expected. It is key that women at increased risk are identified. Premenopausal and menopausal women should be encouraged to exercise and maintain adequate calcium intake. Menopausal women should be encouraged to consider estrogen replacement therapy, and those with risk factors who decline estrogen replacement therapy should be recommended for bone density measurements. Women with low bone density or established osteoporosis should be offered estrogen replacement, alendronate, or calcitonin therapy. Application of these new tools and treatments by obstetrician-gynecologists may reduce the number of osteoporotic fractures experienced by our aging population.