Management of Osteoporosis in Postmenopausal Women in Shiraz, Southern Iran
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
City, Province: Firouzabad, Fars
Keywords: Osteoporosis; Prevention; Treatment; Menopause
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.
- Warriner AH, Outman RC, Saag KG, Berry SD, Colón-Emeric C, Flood KL, Lyles KW, Tanner SB, Watts NB, Curtis JR. Management of Osteoporosis Among Home Health and Long-Term Care Patients with a Prior Fracture. South Med J 2009 (In press). 
- Lash RW, Nicholson JM, Velez L, Van Harrison R, McCort J. Diagnosis and management of osteoporosis. Prim Care 2009;36:181-98.  [doi:10.1016/j.pop.2008.10.009]
- Vondracek SF, Hansen LB, McDermott MT. Osteoporosis risk in premenopausal women. Pharmacot-herapy 2009;29:305-17.  [doi:10.1592/phco.29.3.305]
- National osteoporosis foundation. Physicians guide: pharmacology options. Available at: http://www. nof. Org/ physguide/ pharmacologic. Htm. Accessed February 23/2006.
- Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag 2008;4:827-36. 
- Buki, Regular, Cortland forum, Menopause management, park 2. Maintaining late menopausal health, 2000, http: // web 14.epnet. com/citation. Asp?tb
- Walf U, H Gallgher, J christper,Lindsay. R, Mcclung Michael , Nelson M. Postememopausal Osteprosis. Stategies for Prevention and treatment. The North American Menopause Society 2001;1-25.
- Gill J, Hoffman M. Preventation and treatment of osteoprosis in primary care office. J Womens Health (Larchmt) 2003;12:473-80.  [doi:10.1089/154099903766651595]
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- Hajcsar EE, Hawker G, Bogoch ER. Investigtion and treatment of osteoporosis on patients with fragility fractures. CMAJ 2000;163:819-822.