Osteoporosis is perhaps the widest-ranging social, physical, and economic impact of estrogen deficiency. Postmenopausal bone loss is the major determinant of osteoporosis. Osteoporotic risk can be determined by measuring bone mineral density using dual X-ray absorptiometry. The radiation free quantitative bone ultrasound is emerging in the assessment of bone structure giving reliable estimates of fracture risk. Diet and exercise are important in determining a woman's risks for osteoporosis. Hormone replacement therapy clearly decreases bone turnover and prevents postmenopausal bone loss and reduces fractures. Tibolone as well as raloxifene prevent bone loss and solid data demonstrate a reduction of vertebral fractures after raloxifene administration.
Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology ‘Piero Fioretti’, University of Pisa, Italy
Correspondence to Marco Gambacciani, Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology ‘Piero Fioretti’, University of Pisa, Via Roma 67, 56100 Pisa, Italy. Tel: +39 050 992385; fax: +39 050 553410; e-mail: firstname.lastname@example.org