Common Questions
What risk factors (not including secondary causes) would prompt you to screen for osteoporosis in a postmenopausal woman younger than 65?
In addition to personal fracture (including vertebral fracture seen radiographically), there are several other independent risk factors for osteoporosis (see below). However, it is controversial which ones warrant early screening and organizations use different risk factor criteria for recommending screening prior to age 65 in postmenopausal women (1-5).
Independent Risk Factors for Osteoporosis
- History of a fragility fracture in a first degree relative
- Weight less than 127 lbs or BMI < or = 20)
- Current smoker (> 1 PPD)
- Alcoholism (> 2 drinks daily)
- Menopause before age 40
- Currently or previously treated with >3 months of glucocorticoid therapy at a dosage of 5 mg/d or more of Prednisone
| Group(s) | Recommendation |
|---|---|
|
Postmenopausal women of any age if one of more risk factors present |
| US Preventive Services Task Force | Women 60 years and older who are at increased risk for fractures (risk factors not specified) |
- Screening for Postmenopausal Osteoporosis: A Review of the Evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2002; 529-41.
- National Institutes of Health Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA 2001; 285: 785-795.
- Hodgson SF, Watts NB, Bilezikian JP, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract 2003; 9: 544-564.
- Management of postmenopausal osteoporosis: position statement of The North American Menopause Society. Menopause 2002; 9: 84-101.
- Institute for Clinical Systems Improvement (ICSI). Diagnosis and Treatment of Osteoporosis. 4th Ed. Bloomington, Minn: Institute for Clinical Systems Improvement (ICSI) 2005.