Preventing Osteoporosis in Postmenopausal Women: Treatment Approaches for Family Physicians

Abstract

Osteoporosis is defined as a systemic skeletal disorder that reduces the strength of bone, resulting in an increased risk of fracture. Fractures occur, even if an individual is subjected to minimal trauma such as a fall from own body height. The most common osteoporotic fractures are fractures of the vertebrae, femur neck and distal forearm but other peripheral fractures also play an important role. Osteoporotic fractures are common and will affect at least a third of women over the age of 50 years.1 It not only leads to significant morbidity, but also increased mortality. Osteoporosis is an age-related disease. In view of expectations that life expectancy is on the rise, the scope of the problem and the burden of the disease will escalate in future. The incidence of osteoporotic fractures in South Africa has not been recorded and most of our calculations are derived from Europe and North America. A false impression has been created that Black South Africans are not prone to osteoporosis. It is true that ethnic Blacks have a lesser tendency to fracture at equivalent bone mineral density (BMD) values than do Europeans. This should however not distract from the fact that many Blacks suffer from the avoidable consequences of osteoporotic fractures. The prevention of osteoporotic fractures is a national priority for all our people. It is therefore obvious that the modern family physician needs to have a basic knowledge of the disease condition and a strategy for the prevention of fractures.