Application of new therapeutic approaches in the prevention of osteoporosis in women

The prevention of female osteoporosis is based on: a) promoting the achievement of optimal bone mass at the time of menopause; b) minimizing subsequent rarefaction especially in fast bone losers. Both these objectives can be partly attained by appropriate behaviour (balanced diet with adequate calcium intake, physical exercise) but often with additional preventive treatment that is undoubtedly easier to undertake since the introduction of new therapeutic approaches like the use of transdermal estradiol (TDE) and the salmon calcitonin (CT) nasal spray. Certain situations, chronic hypo-estrogenism (amenorrhea caused by primary ovarian deficit and primary or secondary hypothalamic hypogonadotropinemia) should be rectified by replacement estrogen-progestin treatment before the onset of menopause. Protracted treatment of this kind can also be used beneficially in patients identified as at risk of osteoporosis during the climacteric and where it is advisable to minimise the hepatocellular action of the estrogens TDE will be the treatment of choice. In both phases the CT spray can be used preventively wherever there are contraindications to the use of the estrogens and a real risk of osteoporosis.