Osteoporosis: A Practical Approach to the Perimenopausal Woman

Osteoporosis is one of the most important health issues women face as they age. The complications of osteoporosis, fracture of sites such as the vertebral spine, the hip, and the arm, account for an enormous toll in quantity and quality of life. Osteoporosis is taking an increasing share of the bill for medical care in this country. The best approach to the problem of osteoporosis is to prevent it. Prevention of osteoporosis requires attention to issues of diet and lifestyle that are relevant even in childhood. The time in a woman's life when the menopause is imminent, the perimenopausal period, is a particularly important time to take stock of risk factors and measures that can be taken to reduce the likelihood of developing osteoporosis. The evaluation should begin with a physician well versed in the means by which bone loss can be assessed accurately. It includes a review of family history, information from childhood and young adulthood that has an impact on achievement of peak bone mass, and appropriate diagnostic tests. With this information, the perimenopausal woman and her physician can embark on a program that is suited to her and that maximizes every opportunity to maintain bone mass in the postmenopausal period of life.