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Evaluation and treatment of premenopausal osteoporosis

Carolyn B Becker, MD
Adi Cohen, MD, MHS
Section Editor
Clifford J Rosen, MD
Deputy Editor
Jean E Mulder, MD


Few data exist to guide clinical care for premenopausal women who have low bone density (Z-score less than or equal to -2.0) and/or fragility fractures. The guidelines for the treatment of osteoporosis based on bone mineral density (BMD) in postmenopausal women do not generally apply to premenopausal women, as the relationship between bone mass and fracture in premenopausal women is not the same as in postmenopausal women. BMD alone should not be used to define osteoporosis in a premenopausal woman but, like fragility fractures, is an indication for further evaluation.

This topic reviews the evaluation and treatment of premenopausal osteoporosis. The epidemiology and etiology are reviewed separately. (See "Epidemiology and etiology of premenopausal osteoporosis".)


Bone density screening is not routinely recommended for premenopausal women [1]. However, healthy premenopausal women with concerns about bone health or risk factors for osteoporosis may request a bone mineral density (BMD) test and seek expert advice if results are abnormal.

We agree with the International Society of Clinical Densitometry (ISCD) guidelines (table 1) that suggest BMD screening for premenopausal women under the following circumstances [1]:

History of a fragility fracture

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Literature review current through: Oct 2017. | This topic last updated: Jul 17, 2017.
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