Focus on primary care postmenopausal osteoporosis: an update.

Osteoporosis is a common and costly condition that can cause disability or death. Evaluation of patients for possible secondary causes is important. Bone density testing permits identification of individuals who are at high risk of fracture and is recommended for all women age 65 and older and for younger women who have clinical risk factors. Measurement of bone markers, particularly collagen cross links, may add some information. Adequate calcium, vitamin D, and weight-bearing exercise are important for everyone and are fundamental to any program for prevention of bone loss or treatment of osteoporosis. Effective pharmacologic agents are available for prevention of bone loss in recently menopausal women and for treatment of established osteoporosis. Pharmacologic intervention is indicated for women who have osteoporosis, defined either as a fracture or BMD T-score of -2.5 and below.