The prevention and treatment of osteoporosis

Low bone mass is the most important preventable cause of fractures. These fractures affect 1.5 million Americans yearly with an annual cost to the United States health care system of at least $10 billion. This decrease in bone mass, osteoporosis, is concentrated in the spinal column and at the ends of the long bones, particularly in women. During their lifetimes, women lose about 50% of reticular bone while men lose only 30%. Women lose 30% of cortical bone, and men, 20%. Drugs can either prevent bone mass decrease, as estrogen replacement and calcium supplements after menopause or increase bone formation, as sodium fluoride or parathyroid hormone. Postmenopausal women can prevent osteoporosis by weight bearing exercise to increase lumbar spine density plus estrogen therapy for women under age 75. High dosages of calcium supplements for both men and postmenopausal women are also recommended.