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Postmenopausal Osteoporosis: Menopause Hormone Therapy and Selective Estrogen Receptor Modulators

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Abstract

Introduction

Osteoporosis is a debilitating silent disease with a huge socio-economic impact. Prevention strategies and early detection of osteoporosis need to be carried out in every health care unit to substantially reduce the fracture rates. Indian studies have indicated a knowledge gap on diagnosis and management of osteoporosis amongst medical professionals and consumers.

Areas Covered

This article reviews the evidences available on searches from PubMed and The National Library of Medicine, author's opinions based on clinical experience. There is a need for escalating the efforts to bridge the knowledge gap regarding various aspects of osteoporosis amongst professionals and consumers. Three indications for postmenopausal hormone therapy (HT), which have constantly withstood the test of time, are symptom relief, urogenital atrophy, and bone health. This article specifically focuses on management of postmenopausal osteoporosis by HT alone or in combinations.

Expert Opinion

Early menopause is within 10 years of menopause and late menopause is considered beyond 10 years of menopause. HT is a cost-effective therapy in the early post menopause especially in symptomatic women at risk for osteoporosis unless contraindicated. HT prevents all osteoporotic fractures even in low-risk population. All HT preparations including low dose and non-oral routes of estrogen are effective for bone health. The bone protective effect lasts while on HT. Extended use of HT in women after 10 years of menopause with reduced bone mass is an option after detailed counselling of the risk benefit analysis compared with the other available therapies for osteoporosis. The primary therapy to prevent bone loss in women with premature menopause and secondary amenorrhea is HT. HT work up and annual follow-up is essential before prescribing HT.

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Authors and Affiliations

  1. IGIMS, Patna, Bihar, India

    Jyotsna Rani

  2. AIIMS, Deoghar, Jharkhand, India

    Swati Swati

  3. Tanvir Hospital, Hyderabad, India

    Meeta Meeta, Sardar Harinder Singh, Tanvir Tanvir & Akanshi Madan

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  1. Jyotsna Rani
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  2. Swati Swati
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Correspondence to Jyotsna Rani.

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Rani, J., Swati, S., Meeta, M. et al. Postmenopausal Osteoporosis: Menopause Hormone Therapy and Selective Estrogen Receptor Modulators. JOIO 57 (Suppl 1), 105–114 (2023). https://doi.org/10.1007/s43465-023-01071-6

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