An update for the obstetrician-gynecologist on advances in the diagnosis, prevention, and treatment of postmenopausal osteoporosis.

Improvements in bone densitometry and new biochemical tests allow early detection and prevention of postmenopausal bone loss. Interventions for osteoporosis-prone women include correction of adverse habits and lifestyles, optimization of calcium and vitamin D intake, and prescription of estrogen. Recent studies indicate that elderly women may still obtain significant benefit from estrogen. Calcitonin is an approved alternative to estrogen, and recent studies confirm its ability to prevent bone loss and fractures, even when administered intranasally. This review also summarizes clinical investigation of newer, yet unapproved, methods of treatment; the most promising of these treatments are the bisphosphonates, fluoride, and tamoxifen.