Management of Osteoporosis in Postmenopausal Women in Shiraz, Southern Iran

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Article Information:

Group: 2009
Subgroup: Volume 11, Issue 2
Date: April 2009
Type: Letter to Editor
Start Page: 222
End Page: 223


  • Paymaneh Shokrollahi
  • Instructor of Department of Nursing and Midwifery, Firouzabad Azad University, Firouzabad, Fars, Iran
  • M Abtan
  • Department of Nursing and Midwifery, Firouzabad Azad University, Firouzabad, Fars, Iran
  • ZH Najafi
  • Department of Nursing and Midwifery, Firouzabad Azad University, Firouzabad, Fars, Iran
  • M Rivaz
  • Department of Nursing and Midwifery,Hazrat Fatemeh Nursing and Midwifery College, Shiraz University of Medical Sciences, Shiraz, Fars, Iran


      Affiliation: Instructor of Department of Nursing and Midwifery, Firouzabad Azad University
      City, Province: Firouzabad, Fars
      Country: Iran
      Tel: +98-917-7131961
      Fax: +98-712-6224402



Keywords: Osteoporosis; Prevention; Treatment; Menopause

Manuscript Body:

Dear Editor,

Osteoporosis is a still a health concern with significant morbidity and mortality due to an increase of senior adults worldwide. Falls and fractures are common among frail older adults needing home health and long-term care.1,2 Although clinically bone loss and fractures in healthy premenopausal women are sporadic, more women search evaluation for osteoporosis from health care providers.3 National osteoprosis Foundation estimates that in the united states 10 million individuals, 80% of women, already have osteoprosis, with an additional 34 million individuals at risk because of low bone mass. 4 Preventative measures to reduce falls have been identified and many therapies (both prescription and nonprescription) with proven efficacy for reducing fracture risk are available.1

Calcium and vitamin D utilization in the optimization of bone health is often overlooked by patients and health care providers. In addition, the optimal standard of care for osteoporosis should encompass adequate calcium and vitamin D intake.5 There is increasing evidence that the risk of osteoprosis in postmenopausal women can be reduced with calcium supplements, estrogen replacement therapy (ERT) and other Medications.6 This study was performed to determin the  preventive and treatment measures of osteoporpsis in postmenopausal women in Shiraz, southern Iran.

From June 2005 to October 2006, 405 post-menopausal women 55 years old referring to Shiraz Health centers entered the study. A questioner was completed as described by Walf et al.7 A written consent was provided from each participant and the study was approved by the university Ethics Committee.

Of participants, 49.6% were <60 years and 1% were older with a mean age of 61.98 years (mean age of menopauses= 49.3 y/o) and 37% of  menopaused were 45-50 y/o. 96.3% of woman had at least one risk factor of osteoprosis while 78% were in relation to life style. Only 21.7% of women had done a BMD test. 77.3% of women had available test results indicating to osteoporosis (7 had X-Ray and 51 BMD). Only 20.5% of women had history of calcium and vitamin D supplement daily during the last year (6.7% bisphosphonate, 2.5% calcium, 4.9% ERT and HRT). Prevention and treatment medication intake showed a significant difference  between osteoporotic women and those without osteoporosis (p=0.05).

Gill and Hofmen in 132 menopause women > 55 year reported a 34% BMD test,8 which is less than our result (21.7%). NIH recommend BMD test for menopause women every two years, and for high risk women every year in addition for women with positive history of fragility fracture.9

Sunvecz showed that when pharmacologic therapy is advised, continued use of calcium and vitamin D is recommended for optimal fracture risk reduction.5 In Hajcsar et al.'s study on 228  samples, 32.4% took calcium, 13% vitamin D and 4.7% bisphosphonate supplement.10

Our results showed that management of osteoporosis in menopausal women in southern Iran, are so far from the recommended guidlines. So, there is a need to educate the women and high risk groups of osteoporosis for preventive and therapeutic measures.





The authors would like to thank the Office of Vice Chancellor of Firoozabad Islamic Azad University for financial support.



Conflict of interest: None declared.

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