Bocci A, Campagnoli C, Ardizzoia M
Minerva Endocrinol. 1989 Jan-Mar;14(1):75-80.
The prevention of female osteoporosis is based on: a) promoting the achievement of optimal bone mass at the time of menopause; b) minimizing subsequent rarefaction especially in fast bone losers. Both these objectives can be partly attained by appropriate behaviour (balanced diet with adequate calcium intake, physical exercise) but often with additional preventive treatment that is undoubtedly easier to undertake since the introduction of new therapeutic approaches like the use of transdermal estradiol (TDE) and the salmon calcitonin (CT) nasal spray. Certain situations, chronic hypo-estrogenism (amenorrhea caused by primary ovarian deficit and primary or secondary hypothalamic hypogonadotropinemia) should be rectified by replacement estrogen-progestin treatment before the onset of menopause. Protracted treatment of this kind can also be used beneficially in patients identified as at risk of osteoporosis during the climacteric and where it is advisable to minimise the hepatocellular action of the estrogens TDE will be the treatment of choice. In both phases the CT spray can be used preventively wherever there are contraindications to the use of the estrogens and a real risk of osteoporosis.
a）促进在绝经时达到最佳骨量；b）尽量减少随后的骨质流失，尤其是在骨量快速流失者中。这两个目标部分可以通过适当的行为（摄入足够钙的均衡饮食、体育锻炼）来实现，但通常还需要额外的预防性治疗。自从引入新的治疗方法，如使用经皮雌二醇（TDE）和鲑鱼降钙素（CT）鼻喷雾剂以来，这种治疗无疑更容易实施。某些情况，如慢性低雌激素血症（由原发性卵巢功能不全和原发性或继发性下丘脑性性腺功能减退引起的闭经），应在绝经前通过雌激素 - 孕激素替代治疗来纠正。这种长期治疗也可有益地用于在更年期被确定有骨质疏松症风险且建议尽量减少雌激素肝细胞作用的患者，TDE将是首选治疗方法。在这两个阶段，只要存在雌激素使用禁忌证且存在真正的骨质疏松症风险，CT喷雾剂都可用于预防性治疗。
