Article - Journal Bone Fragility

MMichael R. McClung, Amanda L. Clark
Concise reviews, 79-83
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Rapid bone loss and substantial deterioration of bone microarchitecture occur during late perimenopause and early postmenopause, an interval termed transmenopause, contributing significantly to the development of postmenopausal osteoporosis. Low body weight and low bone mineral density at the onset of perimenopause accurately identify women at high risk of developing osteoporosis. Screening women as they enter perimenopause allows identification of those high-risk patients for whom therapy with either estrogen or low-dose bisphosphonates should be considered to prevent menopause-related bone loss. Each of these options has advantages and limitations, and the choice must be individualized. Following therapy to prevent rapid transmenopausal bone loss, a lifelong strategy to preserve bone density and prevent the development of osteoporosis and high fracture risk is necessary.
KEY WORDS: Perimenopause, transmenopause, menopause, osteoporosis, estrogen, bisphosphonates, prevention.