Management of Postmenopausal Osteoporosis: ACOG Clinical Practice Guideline No. 2 : Obstetrics & Gynecology

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Management of Postmenopausal Osteoporosis

ACOG Clinical Practice Guideline No. 2

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Obstetrics & Gynecology 139(4):p 698-717, April 2022. | DOI: 10.1097/AOG.0000000000004730



To provide updated evidence-based recommendations for the treatment of postmenopausal osteoporosis.


Postmenopausal patients with primary osteoporosis.


This guideline was developed using an a priori protocol in conjunction with a writing team consisting of two specialists in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines–Gynecology and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements.


This Clinical Practice Guideline includes updated recommendations on who should receive osteoporosis pharmacotherapy, the benefits and risks of available pharmacotherapy options, treatment monitoring and follow-up, and the role of calcium and vitamin D in the management of postmenopausal osteoporosis. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.


In “Clinical Practice Guideline No. 2” from the American College of Obstetricians and Gynecologists,1 there is an error in the document's reference citation listed on page 717. The publication year is erroneously listed as “2021.” The full, corrected citation is as follows: “Management of postmenopausal osteoporosis. Clinical Practice Guideline No. 2. American College of Obstetricians and Gynecologists. Obstet Gynecol 2022;139:698–717.” doi: 10.1097/AOG.0000000000004730.

Obstetrics & Gynecology. 140(1):138, July 2022.

© 2022 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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