Skip to main content
SpringerLink
Log in

Osteoporosis and the Perimenopausal Woman

  • Chapter
Perimenopause

Part of the book series: Serono Symposia USA ((SERONOSYMP))

  • 106 Accesses

Abstract

To reduce the risk of developing osteoporosis, women should maximize their peak bone mass and minimize subsequent bone loss. Most studies have examined ways of preventing postmenopausal bone loss, but few have examined bone loss in pre- and perimenopausal women. Changes in bone density that occur in women who are between age 30 and 35 years (when peak bone mass has been achieved) and age at menopause are reviewed. This chapter focuses particularly on the events that occur as ovarian function wanes, usually between age 45 and 50. The influence of aging and hormone deficiency on bone mineral density are examined, and the effectiveness of various interventions to prevent pre- and perimenopausal bone loss are reviewed. These strategies include muscle-building exercise, calcium supplementation, and estrogen replacement therapy. Finally, the advantages and disadvantages of performing bone density assessment as a screening procedure for all perimenopausal women are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Block JE, Smith R, Glueer C-C, Steiger P, Ettinger B, Genant HK. Models of spinal trabecular bone loss as determined by quantitative computed tomography. J Bone Miner Res 1989;4:249–57.

    Article  PubMed  CAS  Google Scholar 

  2. Rodin A, Murby B, Smith MA, et al. Premenopausal bone loss in the lumbar spine and neck of femur: a study of 225 Caucasian women. Bone 1990;11:1–5.

    Article  PubMed  CAS  Google Scholar 

  3. Cann CE, Genant HK, Kolb FO, Ettinger B. Quantitative computed tomography for prediction of vertebral fracture risk. Bone 1985;6:1–7.

    Article  PubMed  CAS  Google Scholar 

  4. Buchanan JR, Myers C, Lloyd T, Greer RB III. Early vertebral trabecular bone loss in normal premenopausal women. J Bone Miner Res 1988;3:583–7.

    Article  PubMed  CAS  Google Scholar 

  5. Katzman DK, Bachrach LK, Carter DR, Marcus R. Clinical and anthropometric correlates of bone mineral acquisition in healthy adolescent girls. J Clin Endocrinol Metab 1991;73:1332–9.

    Article  PubMed  CAS  Google Scholar 

  6. Mazess RB. On aging bone loss. Clin Orthop 1982;165:239–52.

    PubMed  Google Scholar 

  7. Recker RR, Davies KM, Hinders SM, Heaney RP, Stegman MR, Kimmel DB. Bone gain in young adult women. JAMA 1992;268:2403–8.

    Article  PubMed  CAS  Google Scholar 

  8. Kaners B, Dempster DW, Lindsay R. Interaction of calcium nutrition and physical activity on bone mass in young women. J Bone Miner Res 1988; 3:145–9.

    Article  Google Scholar 

  9. Hansen MA. Assessment of age and risk factors on bone density and bone turnover in healthy premenopausal women. Osteoporos Int 1994;4:123–8.

    Article  PubMed  CAS  Google Scholar 

  10. Mazess RB, Barden HS. Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr 1991;53:132–42.

    PubMed  CAS  Google Scholar 

  11. Riggs BL, Wahner WH, Dunn WL, Mazess RB, Offord KP, Melton LJ III. Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest 1981; 67:328–35.

    Article  PubMed  CAS  Google Scholar 

  12. Riggs BL, Melton LJ III. Involutional osteoporosis. N Engl J Med 1986; 314:1676–86.

    Article  PubMed  CAS  Google Scholar 

  13. Hedlund LR, Gallagher JC. The effect of age and menopause on bone mineral density of the proximal femur. J Bone Miner Res 1989;4:639–42.

    Article  PubMed  CAS  Google Scholar 

  14. Citron JT, Ettinger B, Genant HK. Spinal bone mineral loss in estrogen-replete, calcium-replete premenopausal women. Osteoporos Int 1995;5:228–33.

    Article  PubMed  CAS  Google Scholar 

  15. Riggs BL, Wahner HW, Melton LJ III, Richelson LS, Judd HL, O’Fallon WM. Dietary calcium intake and rates of bone loss in women. J Clin Invest 1987;80:979–82.

    Article  PubMed  CAS  Google Scholar 

  16. Smith EL, Gilligan C, Smith PE, Sempos CT. Calcium supplementation and bone loss in middle-aged women. Am J Clin Nutr 1989;50:833–42.

    PubMed  CAS  Google Scholar 

  17. Friedlander AL, Genant HK, Sadowsky S, Bly NN, Glüer C-C. A two-year program of aerobics and weight training enhances bone mineral density of young women. J Bone Miner Res 1995;10:574–85.

    Article  PubMed  CAS  Google Scholar 

  18. Baran D, Sorensen A, Grimes J, et al. Dietary modification with dairy products for preventing vertebral bone loss in premenopausal women: a three-year prospective study. J Clin Endocrinol Metab 1989;70:264–70.

    Article  Google Scholar 

  19. Ettinger B, Drinkwater BL. Calcium and exercise: alternatives or adjuncts to estrogen in prevention of osteoporosis. In: Swartz DP, ed. Hormone replacement therapy. Baltimore: Williams & Wilkins, 1992:79–108.

    Google Scholar 

  20. Riggs BL, Wahner HW, Melton LJ III, Richelson LS, Judd HL, Offord KP. Rates of bone loss in the appendicular and axial skeletons of women: evidence of substantial vertebral bone loss before menopause. J Clin Invest 1986; 77:1487–91.

    Article  PubMed  CAS  Google Scholar 

  21. Slemenda C, Hui SL, Longcope C, Johnston CC. Sex steroids and bone mass: a study of changes about the time of menopause. J Clin Invest 1987;80:1261–9.

    Article  PubMed  CAS  Google Scholar 

  22. Sowers MF, Clark MK, Hollis B, Wallace RB, Jannausch M. Radial bone density in pre- and perimenopausal women: a prospective study of rates and risk factors for loss. J Bone Miner Res 1992;7:647–57.

    Article  PubMed  CAS  Google Scholar 

  23. Dawson-Hughes B, Dallai GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990;323:878–83

    Article  PubMed  CAS  Google Scholar 

  24. Falch JA, Oftebro H, Haug E. Early postmenopausal bone loss is not associated with a decrease in circulating levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, or vitamin D-binding protein. J Clin Endicrinol Metab 1987;64:836–41

    Article  CAS  Google Scholar 

  25. Steinberg KK, Freni-Titulaer LW, DePuey EG, et al. Sex steroids and bone density in premenopausal and perimenopausal women. J Clin Endocrinol Metab 1989;69:533–9

    Article  PubMed  CAS  Google Scholar 

  26. van Beresteijn ECH van’t Hof MA, Schaafsma G, de Waard H, Duursma SA. Habitual dietary calcium intake and cortical bone loss in perimenopausal women: a longitudinal study. Calcif Tissue Int 1990;47:338–44

    Article  PubMed  Google Scholar 

  27. Gambacciani M, Spinetti A, Taponeco F, Cappagli B, Piaggesi L, Fioretti P. Longitudinal evaluation of perimenopausal vertebral bone loss: effects of a low-dose oral contraceptive preparation on bone mineral density and metabolism. Obstet Gynecol 1994;83:392–6

    PubMed  CAS  Google Scholar 

  28. Elders PJM, Netelenbos JC, Lips P, et al. Calcium supplementation reduces vertebral bone loss in perimenopausal women: a controlled trial in 248 women between 46 and 55 years of age. J Clin Endocrinol Metab 1991;73:533–40.

    Article  PubMed  CAS  Google Scholar 

  29. Zhang J, Feldblum PJ, Fortney JA. Moderate physical activity and bone density among perimenopausal women. Am J Public Health 1992;82:736–8.

    Article  PubMed  CAS  Google Scholar 

  30. Shargill AA. Hormone replacement therapy in perimenopausal women with a triphasic contraceptive compound: a three-year prospective study. Int J Fertil 1985;30:15,18–28.

    Google Scholar 

  31. Williams SR, Frenchek B, Speroff T, Speroff L. A study of combined continuous ethinyl estradiol and norethindrone acetate for postmenopausal hormone replacement. Am J Obstet Gynecol 1990;162:438–46.

    PubMed  CAS  Google Scholar 

  32. Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC Jr. Predictors of bone mass in perimenopausal women: a prospective study of clinical data using photon absorptiometry. Ann Intern Med 1990;112:96–101.

    PubMed  CAS  Google Scholar 

  33. Cummings SR, Black D. Should perimenopausal women be screened for osteoporosis? Ann Intern Med 1986;104:817–23.

    PubMed  CAS  Google Scholar 

  34. Rubin SM, Cummins SR. Results of bone densitometry affect women’s decisions about taking measures to prevent fractures. Ann Intern Med 1992;116(12, Pt 1):990–5.

    PubMed  CAS  Google Scholar 

  35. Ettinger B, Grady D. Maximizing the benefit of estrogen therapy for prevention of postmenopausal osteoporosis. Menopause 1994;1:19–24.

    Article  Google Scholar 

  36. Tosteson ANA, Rosenthal DI, Melton LJ III, Weinstein MC. Cost effectiveness of screening perimenopausal white women for osteoporosis: bone densitometry and hormone replacement therapy. Ann Intern Med 1990;113:594–603.

    PubMed  CAS  Google Scholar 

  37. US Congress, Office of Technology Assessment. Effectiveness and costs of osteoporosis screening and hormone replacement therapy, vol. 1: cost-effectiveness analysis. OTA-BP-H-160. Washington DC: US GPO, August 1995.

    Google Scholar 

  38. Ettinger B. Hormone replacement therapy and coronary heart disease. Obstet Gynecol Clin North Am 1990;17:741–57.

    PubMed  CAS  Google Scholar 

  39. Grady D, Rubin SH, Petitti DB, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med 1992;117:1016–37.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Bruce Ettinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA

    Rogerio A. Lobo M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Ettinger, B. (1997). Osteoporosis and the Perimenopausal Woman. In: Lobo, R.A. (eds) Perimenopause. Serono Symposia USA. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-2288-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-2288-0_15

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7488-9

  • Online ISBN: 978-1-4612-2288-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation