Lindsay R
Obstet Gynecol Clin North Am. 1987 Mar;14(1):63-76.
Prevention of osteoporosis is clearly the preferred approach, since treatment of the established disorder is less than satisfactory. However, accurate identification of those at risk for fractures is impossible at present. By judicious use of risk assessment and the addition of bone mass measurements in the postmenopausal patient, the physician can define a group of patients who will be at some increased likelihood of subsequent osteoporosis. Since estrogen therapy is the most effective single agent for prevention of bone loss, estrogens can be recommended for this group of patients, if otherwise not contraindicated. The addition of a progestogen to the regimen may add to the effect of estrogen by stimulating bone formation. Estrogen therapy may have other effects in the postmenopausal patient population that must be considered when deciding about the introduction of therapy.
由于对已确诊疾病的治疗效果不尽人意，预防骨质疏松显然是首选方法。然而，目前尚无法准确识别骨折高危人群。通过审慎运用风险评估并对绝经后患者增加骨量测量，医生能够确定一组后续发生骨质疏松可能性有所增加的患者。由于雌激素疗法是预防骨质流失最有效的单一药物，对于这组患者，若不存在其他禁忌，可推荐使用雌激素。在治疗方案中添加孕激素可能会通过刺激骨形成增强雌激素的效果。在决定是否开始治疗时，必须考虑雌激素疗法在绝经后患者群体中可能产生的其他影响。
