Postmenopausal osteoporosis: prevention versus cure.

Vertebral and femoral neck fracture syndromes and their attendant morbidity still continue to plague the lives of many postmenopausal women. The osteopenia that characterizes the "vertebral collapse" or "hip fracture" syndromes results from the gradual and progressive loss of bone mass the begins early in the fourth decade of life in all individuals and proceeds at an accentuated rate in the female population. A unified hypothesis that effectively explains the pathogenesis of the fracture-prone osteopenia state is still nonexistent, although sedentary life styles, genetic predisposition, hormonal imbalance, vitamin deficiencies, high-protein diets, and cigarette smoking have all been implicated in this regard. One of the most consistent observations, which cannot be ignored, is the inadequate calcium intake of women in the second and third decade of life and the negative calcium balance that characterizes the perimenopausal state. Nutritional adequacy with respect to this most essential skeletal ingredient is considered most appropriate not only in any proposed therapeutic regimen for postmenopausal osteopenic females, but also in the young, active, menstruating female.