Postmenopausal Osteoporosis Evaluation, Diagnosis and Treatment the Focus of Updated Clinical Practice Guidelines and Algorithm Published By American Association of Clinical Endocrinologists/American College of Endocrinology

American Association of Clinical Endocrinologists
(AACE) and the
American College of Endocrinology (ACE) today announced the publication
of new clinical practice guidelines and an accompanying algorithm to
assist physicians and other medical professionals with the diagnosis,
fracture risk assessment and treatment of postmenopausal osteoporosis

The two documents are published in Volume 22, Issue 9 of the
association’s peer-reviewed scientific journal Endocrine Practice:

The CDC estimates that 16 percent of U.S. women 50 years of age and
older suffer from osteoporosis, a disease of abnormal bone loss that
frequently results in debilitating fractures — particularly of the
spine and hip — that lead to years of pain and disability. Recent
analysis suggests that the annual cost of caring for osteoporotic
fractures exceeds the annual costs of caring for breast cancer,
myocardial infarction (heart attack), or stroke in women aged 55 years
and older.

Despite the prevalence of the disease in the baby boomer generation and
the associated costs, less than one in four women aged 67 years or older
with an osteoporosis-related fracture undergo bone density measurement
or begin osteoporosis treatment.

To address this public health issue, the AACE/ACE guidelines offer key
recommendations, among them:

  • All postmenopausal women aged 50 and older
    should undergo clinical assessment for osteoporosis and fracture risk,
    including a detailed history and physical examination using tools such
    as the World Health Organization’s (WHO) clinical fracture risk
    assessment (FRAX®), when available.
  • Bone mineral density (BMD) testing (which uses x-rays to measure how
    many grams of calcium and other bone minerals are present in the bone
    segment) is recommended in women aged 65 and older as well as younger
    postmenopausal women at increased risk for bone loss and fracture,
    based on fracture risk analysis.
  • Because of the high prevalence of secondary osteoporosis, a condition
    in which diseases that affect the body secondarily affect the
    skeleton, medical evaluation is indicated in all women with
    postmenopausal osteoporosis and at high fracture risk to identify
    co-existing medical conditions that may be causing or contributing to
    the patient’s bone loss.
  • In terms of pharmacologic therapy, those patients with lower or
    moderate fracture risk can be started on oral agents, while injectable
    agents can be considered as initial therapy for those who have the
    highest fracture risk. Until the effect of combination therapy on
    fracture risk is better understood, AACE does not recommend such use
    of pharmaceutical agents for osteoporosis prevention or treatment.

“With the increasing impact of postmenopausal osteoporosis on quality
and quantity of life as our citizens age, it is imperative that we offer
efficient, effective evaluation and treatment for those who may be
suffering from this devastating disease,” said Pauline Camacho, MD,
FACE, co-chair of the AACE Osteoporosis Task Force and AACE President.
“These guidelines incorporate the latest evidence and expert opinion to
offer physicians, regulatory bodies and interested laypersons the
information needed to reduce the risk of osteoporosis-related fractures.”

“Increasingly there has been concern about prolonged use of
bisphosphonates and rare adverse events such as osteonecrosis of the jaw
and atypical femoral fractures,” she added. “The guidelines will have
recommendations on the duration of therapy based on severity of
osteoporosis and fracture risk. We hope these recommendations will guide
clinicians in the long-term care of osteoporosis patients.”

To view the AACE guidelines please click here:
To view the algorithm, please click here:

About the American Association of Clinical
Endocrinologists (AACE)

The American Association of Clinical Endocrinologists (AACE) represents
more than 7,000 endocrinologists in the United States and abroad. AACE
is the largest association of clinical endocrinologists in the world.
The majority of AACE members are certified in endocrinology, diabetes
and metabolism and concentrate on the treatment of patients with
endocrine and metabolic disorders including diabetes, thyroid disorders,
osteoporosis, growth hormone deficiency, cholesterol disorders,
hypertension and obesity. Visit our site at

About the American College of Endocrinology

The American College of Endocrinology (ACE) is the charitable,
educational and scientific arm of the American Association of Clinical
Endocrinologists (AACE). ACE is the leader in advancing the care and
prevention of endocrine and metabolic disorders by: providing
professional education and reliable public health information;
recognizing excellence in education, research and service; promoting
clinical research and defining the future of Clinical Endocrinology. For
more information, please visit

About the Journal

, the official journal of the American College of
Endocrinology (ACE) and the American Association of Clinical
Endocrinologists (AACE), is a peer-reviewed journal published twelve
times a year. The Journal publishes the latest information in the
treatment of diabetes, thyroid disease, obesity, growth hormone
deficiency, sexual dysfunction and osteoporosis, and contains original
articles, case reports, review articles, commentaries, editorials,
visual vignettes, as well as classified and display advertising. Special
issues of Endocrine Practice also include AACE clinical
practice guidelines and other AACE/ACE white papers. Complete content is
available on the Endocrine Practice website.


American Association of Clinical Endocrinologists
Glenn Sebold,
904-353-7878 ext. 122