Pharmacological Management of Osteoporosis in Postmenopausal Women

Publication Date: February 18, 2020

Key Points

Key Points

Treat high risk individuals - particularly those with previous fracture.

Consider bisphosphonates as the first line therapeutic choice for postmenopausal women at high risk of fracture.

Reassess fracture risk after patient has been on bisphosphonates for 3-5 years.

Following reassessment, prescribe a “bisphosphonate holiday” for women who are on bisphosphonates and are low-to-moderate risk of fracture.

Consider anabolic therapy (teriparatide or abaloparatide) for women at very high risk of fractures, including those with multiple fractures.

All women undergoing treatment with osteoporosis therapies other than anabolic therapy should consume calcium and vitamin D in their diet or via supplements.

Monitor the BMD of high-risk individuals with a low BMD every 1 to 3 years.

Treatment and Management

...Treatment...

...Who to Trea...

....1: Endocrine Society (ES) recommends...


...Bisphosphon...

...n postmenopausal women at high risk of fr...

...2: In postmenopausal women with osteoporos...


...Denosumab...

...stmenopausal women with osteoporosis who...

...postmenopausal women with osteoporosis...

3.3: In postmenopausal women with osteoporosis ta...


...Teriparatide...

...stmenopausal women with osteoporosis...

...nopausal women with osteoporosis who ha...


...Romosozumab...

...opausal women with osteoporosis at v...

...In postmenopausal women with osteoporosis who h...


Selective...

...stmenopausal women with osteoporos...


...Menopausal Hor...

...pausal women at high risk of fracture a...

....2: In postmenopausal women with osteoporosis...


...Calcitonin...

...ostmenopausal women at high risk of fractur...


...Calcium and Vitami...

...enopausal women with low BMD and at high risk of...

...stmenopausal women at high risk of fracture wi...


...Monitoring

...postmenopausal women with a low BMD and at high...

...e 1. Algorithm for the Management of Post...