••• CHAPTER 33^ Menopause^321
❍ What is the role of osteoblasts?
They deposit the osseous matrix called osteoid (B is for build).
❍ At what age does bone loss begin on most women?
In the spine (trabecular bone), bone loss typically begins at age 20. However, the femur, which is made up of
cortical bone, maximum density is typically in the late 20s.
❍ At what age does bone resorption exceed formation?
40, by about 0.5%.
❍ After menopause, what is the percentage of bone loss per year?
5% per year in trabecular bone, 1% per year total bone loss.
❍ What is the most important factor associated with bone loss?
Age.
❍ What are the other risk factors for osteoporosis?
Family history, early menopause (younger than 45), Caucasian or Asian race, low body weight, smoking, excessive
alcohol use, sedentary lifestyle, low calcium intake, low vitamin D intake, poor health, impaired vision, natural
menopause, surgical menopause, glucocorticoids, and caffeine intake.
❍ What medications are associated with bone loss?
Corticosteroids, thyroid hormone, anticonvulsants, and heparin.
❍ What mechanisms contribute to osteoporosis?
Menopause, thyrotoxicosis, glucocorticoid excess, hyperparathyroidism, multiple myeloma, leukemia or
lymphoma, alcoholism, long-term heparin therapy, immobilization, and metastatic cancer.
❍ What preventive measures can be taken for osteoporosis early in life?
Improved calcium intake, diet, weight-bearing exercise, avoidance of alcohol and smoking, and maintenance of
normal menstrual cycles.
❍ What is the most common site of fractures in menopause?
Vertebral fractures, they account for 50% of all fractures. 25% of women over age 70 will experience vertebral
fractures.
❍ What is the expected loss in height as a result of vertebral fractures in untreated postmenopausal women?
2.5 inches (6.4 cm).
❍ What percentage of patients will die within 1 year after hip fracture?
20%, due to complications of prolonged immobilization.