The role of bisphosphonates in the prevention of postmenopausal osteoporosis

The diminution of bone mineral content is one of the most important consequences of ovarian failure at menopause and its progression towards osteoporosis sets a severe danger for women's health and autonomy. Due to the role of estrogens in bone omeostasis regulation, the success of hormone replacement treatment (HRT) in reversing osteopenia seems quite obvious. HRT then appears to be the most effective way to preserve the bone mineral content (BMC) and the first choice treatment in menopause, due to the manifold advantages patients can get from it. Nevertheless, there are patients to whom HRT cannot be administered, or who would never accept to assume sex steroids, in spite of the need for their bones to be preserved. For these patients bisphosphonates seem particularly indicated due to their effectiveness on bone, which resembles that obtained by HRT, and their limited side-effects.