Standards of prophylaxis and therapy of primary and secondary osteoporosis

Postmenopausal osteoporosis is a major public health problem. It is often insidious and the first sign of it is bone fracture. Presence of bone fractures caused by very small trauma in elderly people is the main cause of raised morbidity. Prevention and effective good treatment of osteoporosis ought to reduce bone fracture risk – the main and most dangerous complication. There are a lot studies about aetiological factors and development of illness. Although diagnosis of osteoporosis depends on bone mineral density measured in the hip (according to the WHO definition), this factor is responsible for bone fractures only in 30 percent of cases. Many other factors such as genetic, other metabolic disorders and chronic diseases are also important and can increase the risk of bone fracture. There are a lot of other cases which influence the presence and development of the disease. Postmenopausal osteoporosis is the most common bone metabolic disturbance. Secondary osteoporosis can be caused by several diseases: endocrine, nephrology, gastrointestinal or carcinomas. In every case there are several recommendations: therapeutic procedures (positive role of physical activity and exercises), well balanced diet and other drugs with proven efficacy in reduction of osteoporotic bone fractures. The optimal treatment duration should be determined on a case-by-case basis according to the results of regular fracture-risk evaluations.