Premenopausal Osteoporosis

Abstract

Osteoporosis in premenopausal women results from low peak bone mass, progressive bone loss or a combination of both. Low bone mineral density in this age group is associated with an increased risk of fractures and stress fractures. Studies have shown that fractures before menopause predict postmenopausal fractures. These findings suggest that certain lifelong traits such as fall frequency, neuromuscular protective response to falls, bone mass and aspects of bone quality and mineralisation affect lifelong fracture risk. In premenopausal women, the relationship between BMD and fracture risk is not so clear compared with the data and correlations in postmenopausal women. Therefore, according to current guidelines, the diagnosis of “osteoporosis” should not be based solely upon BMD measurements in premenopausal women. However, premenopausal women with Colles fractures have been found to have significantly lower BMD at the non-fractured radius, lumbar spine and femoral neck than controls without fractures. So, the International Osteoporosis Foundation (IOF) has recommended maintaining the T-score cut-off of −2.5 at the spine ort hip for diagnosis of osteoporosis in those young adults who have completed growth and who suffer from a chronic disorder known to affect bone mass. Before menopause, the absolute fracture risk is generally low, even at low levels of BMD.