Healthy bones in old age

Osteoporosis is one of the most frequent diseases in postmenopausal women. In spite of the introduction of new diagnostic tools and therapeutic interventions, the incidence of fractures is still increasing. Osteodensitometric procedures such as dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) are equivalent to quantitative ultrasonometry (QUS) in their ability to predict fracture risk. Since estrogen deficiency after menopause is the most important risk factor, gynecologists could play a leading role in future preventive strategies. Therefore, early identification of women at high risk as well as early and individualized preventive measures are essential in the prevention of osteopoosis. Changes in dietary habits as well as an increase in physical activity are of upmost importance. In addition to calcium and vitamin D supplementation, hormone replacement therapy is accepted as the first line and cost effective pharmacological option for the prevention of osteoporosis. In women with established osteoporosis, pharmacological treatment with selective estradiol receptor modulators, bisphosphonates, or fluoride are effective options.