[Postmenopausal osteoporosis--definition, pathogenesis, prevention and therapy].

Osteoporosis represents one of the major health and socioeconomic problems of the modern society. Although numerous risk factors have been identified in the last decade, the pathogenesis of the disorder has not been elucidated yet. However, recent advances in the understanding of the biology of bone as well as the possibility to measure bone mass from the basis for better understanding of the of the pathogenesis of the disorder. In this review article the author discusses current hypotheses of the pathogenesis of osteoporosis with particular view to the role of estrogen deficiency, the role of calcitonin and possible involvement of other hormones and local factors. Histomorphometric studies have shown that osteroporosis is heterogenecus disorder which might explain different results obtained with different therapeutic approaches. It is well accepted that prevention of osteoporosis is more successful and therefore more important than treatment once the bone loss has occurred. In this review the author discusses primary role of estrogen replacement in the prevention of osteoporosis as well as the results of either preventive or therapeutic trials with different medications such as calcium, calcitonin, sodium fluoride and biphosphonates.