Menopausal osteoporosis in the practice of a gynecologist

Abstract

Osteoporosis represents a great healthcare challenge due to an increased risk of fragility fractures that significantly decreases quality of life, shortens life expectancy, and looms as an onerous burden on both the social environment of patients and society as a whole. Osteoporotic fractures can’t be prevented without early diagnosis of low bone mineral density in people at risk. Unfortunately, the population at risk of osteoporosis is not covered by the periodic health examination program in real practice, and involving doctors of different specialties in the prevention and treatment of this disease is one of the options for addressing the challenge. As the risk of osteoporosis is associated with age and estrogen deficiency in women, the gynecologist can and should assume responsibility for the formation of risk groups, monitoring and timely recommendations on preventive and therapeutic actions. The gynecologist’s possibilities should not be reduced solely to recommendations for correcting lifestyle and prescribing menopausal hormone therapy. Antiresorptive agents of the first-line osteoporosis therapy may also be included in the gynecologist’s drug arsenal. Among them are the most commonly used bisphosphonates that are characterized by a good efficacy and safety profile during the long-term use. However, oral administration of bisphosphonates is associated with low compliance due to adverse reactions and the need for strict observance of the rules for their administration. In contrast, intravenous administration of bisphosphonates improves compliance and allows to ensure the optimal treatment outcome. Ibandronate intended for intravenous bolus administration once every three weeks for 5 years is one of the possibilities of using parenteral bisphosphonate therapy in the practice of gynecology.