Case studies

Endocrine causes of osteoporosis. Part 3: Premature ovarian insufficiency

Madhuni Herath, FRANCES MILAT, PHILLIP WONG

Figures

© PHANIE/BURGER/DIOMEDIA ©MOPDHEOLTSOUCSREDIFTOR ILLUSTRATIVE PURPOSES ONLY
© PHANIE/BURGER/DIOMEDIA ©MOPDHEOLTSOUCSREDIFTOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Endocrine causes of osteoporosis, such as primary hyperparathyroidism, hypogonadism, glucocorticoid excess, acromegaly, Cushing’s syndrome and hyperthyroidism, are well-recognised risk factors for decreased bone mineral density. Optimal management of bone health in people with these conditions involves treating the underlying hormonal disease and assessing the need for specific bone preservation therapy. This three-part series discusses three cases to highlight the detrimental impact of specific endocrine diseases on bone health.

Key Points

  • Premature ovarian insufficiency (POI) is defined as amenorrhoea or oligomenorrhoea before the age of 40 years associated with a follicle stimulating hormone level of more than 40 IU/L in women who previously had normal menstrual cycles.
  • Menopausal hormone therapy is recommended in women with POI for the treatment and maintenance of bone health, unless contraindicated.
  • Optimal management of lifestyle factors, such as smoking cessation, adequate dietary calcium intake and exercise, is also recommended.
  • Women with POI and suboptimal bone health despite use of appropriate menopausal hormone therapy warrant referral to an endocrinologist for consideration of nonhormonal antiresorptive therapy.

Figures

© PHANIE/BURGER/DIOMEDIA ©MOPDHEOLTSOUCSREDIFTOR ILLUSTRATIVE PURPOSES ONLY
© PHANIE/BURGER/DIOMEDIA ©MOPDHEOLTSOUCSREDIFTOR ILLUSTRATIVE PURPOSES ONLY