Re: GYN: Osteoporosis/Osteopenia in pre-menopausal women

From: Anna Meenan, MD (annam@uic.edu)
Sun Aug 3 20:51:50 2003


As a woman in her 40's with osteopenia on Dexa (T-1.8), I agree with Doug for the moment. I have a significant family hx of osteoporosis (Grandma with sponaneous fx of hip in her 70's, mom has shrunk an inch in the past few years, ethnic background Danish). I do not plan to take Fosamax in the near future. I do take Ca++/vit.D supplements, drink milk, get weight-bearing exercise (does making rounds in a spread-out hospital count?), and I don't smoke. I had planned to take prempro when I hit menopause (also significant FH of colon polyps/CA) but now I have to rethink that. What do you guys think about this new low-dose Prempro?

--
                                        Anna Meenan, MD

At Sun, 3 Aug 2003, Douglas Krell wrote: > >Dr. Ramirez wrote: > - I won't quarrel with someone giving Fosamax > 35 mgs weekly.... > > I would be very concerned about giving Alendronate to a young woman. > > First of all it has a 10 year half life. > It's a molecule that is deposited in the osteoid matrix that kills osteoclasts resulting in a nearly 90% suppression of bone resorption. Ultimately if you halt resorption too much you also prevent new bone deposition. > BMD testing is an imperfect measure of bone quality... Using Fosamax just to light up the scan a bit, may not tell you anything about bone quality and or osteoporosis related fracture risk reduction 20 or 30 or 40 years later. > That brings up another point...no bone biopsy data past 10 years. And no data on giving this stuff to young women. > > Without an underlying medical cause for bone loss...I agree that a thorough workup is necessary if you are entertaining therapy, > I simply encourage diet, exercise, Calcium. > >-- > Douglas Krell MD FACOG >





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