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Conclusion
Osteoporosis diagnosis and management is clearly defined for postmenopausal women, where the risks for fractures and benefits of treatment have been well studied. Osteoporosis discovery and treatment in younger, premenopausal women is less well defined due to the minimal risk of fractures and lack of large RCTs. Premenopausal osteoporosis is often a result of an underlying condition or medication, and management is dependent on the underlying cause. Although fracture risk in the premenopausal population is low, women with secondary osteoporosis may benefit from treatment. For young women with AN, treatment of the underlying disease is associated with increases in BMD, while hormone therapy does not demonstrate a benefit. In the setting of women undergoing chemotherapy for breast cancer, zoledronic acid has shown promise for improving BMD and may also prevent fractures. GIO may be treated with either the bisphosphonates or teriparatide, since safety and efficacy of these agents are well established in this population. Evidence is also supportive for alendronate in women with CF-associated bone loss. In other conditions, the data are limited to recommend osteoporosis treatment in premenopausal women.
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