Osteoporosis Among Estrogen-Deficient Women—United States, 1988-1994

Each year in the United States, hip fractures result in approximately 300,000 hospital admissions and an estimated $9 billion in direct medical costs. Most of these fractures result from osteoporosis among women who experience accelerated bone loss after natural or surgically induced menopause. Measurement of bone mineral density (BMD) is the best tool available to assess osteoporotic fracture risk for women after menopause; a reduction of one standard deviation (SD) in femoral BMD is comparable to a 14-year increase in age on the risk for hip fracture. A technology that allows highly accurate and precise measurement of BMD is dual energy x-ray absorptiometry (DXA). CDC's Third National Health and Nutrition Examination Survey (NHANES III) was the first nationally representative survey that used DXA to estimate osteoporosis prevalence based on BMD in the U.S. population, providing baseline information for assessing national prevention and intervention needs for this disease. This report compares self-reported health information with BMD measurements from NHANES III conducted during 1988-1994; the findings indicate that most estrogen-deficient women in the United States who had femoral osteoporosis based on BMD were unaware of having this condition, reflecting the evolving nature of research and clinical practice regarding osteoporosis.