Screening and prevention of osteoporosis

Osteoporosis is one of the most frequent illnesses of postmenopausal women in Germany, afflicting approximately 5-6 million. The task of diagnosing this disease falls to gynecologists together with orthopedists, endocrinologists, and radiologists. In addition to the patient's history and physical examination, radiological osteodensitometric procedures and ultrasonographic imaging techniques represent equally effective methods for the prediction of fractures. Since 80-90% of female osteoporosis is caused by the reduced production of ovarian estrogen, gynecologists play the most important role in the prevention of osteoporosis. Preventive treatment should commence in the 1 st decade after menopause. Depending on the individual's risk profile, different possibilities for prevention/treatment are available including a life style and nutrition conducive to healthy bone metabolism, if necessary with calcium and vitamin D supplements, institution of hormone replacement therapy, or treatment with selective estrogen receptor modulators (SERM), bisphosphonates, or fluorides.