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Wednesday, April 16, 2014

Pharmacists Want to Help Gynos Improve Patient Bone Heath

Part of a vigorous life is to have healthy bones. We all want them not only strong but resistant to fracture. We have to take calcium, vitamin D, and should have an overall healthy diet. We have to exercise, and include weight bearing exercise. But is there more too it once menopause starts? Yes, for women, things do change with our bone physiology once menopause starts. The premenopausal woman's ovarian production of estrogen provides a strong drive for that calcium to stay into bones in a greater density. Losing estrogen inevitably causes women to have a dramatically increased bone loss at menopause.  If we look on scans, or at actual bone biopsies like this one, you see the bone structures, on a microscopic level, begin to thin. Thin bones are not as healthy as thicker bones, in most cases. But will that translate into an actual fracture? Young women, who genetically have more stable bones may not have bones that will fracture, as young people may not fall for example. And if not at increased risk for fracture, you may not need medical treatment. This is what the WHO and researchers have tried to convince us with their Frax score . And it's a tool I've been using to discuss bone health with patients about five years now, and it is the newest more sophisticated form of the prediction models that WHO encouraged us to use for several years. But remember, even if you score really well on this exam, there are factors the quiz doesn't include. Not only that but in some discussions by the International Society of Bone Densitometry there are still unanswered questions about overall bone fracture risk prediction. For instance in some  research studies of alendronate if they tried to look at who benefited from medication based on Frax and unfortunately the prediction model did not hold up. What GynoGab prefers: individualize the care. Watch your frax scores over time, take things one year at a time, look at blood tests (calcium levels for one), urine markers, your posture, new medical conditions, find out your VFA (vertebral fracture analysis), get as many facts as possible, especially if you are going to avoid medication. And now in 2014 there has been an emphasis on getting all health care sectors to help in evaluating these scores, and overall factors that contribute to bone health.The pharmacist can improve bone health, and possibly even help patients from ever losing enough bone to become osteoporotic according to a presentation at the American Pharmacists Association (APhA) 2014 Annual Meeting and Exposition in Orlando, Florida by helping women know their risks by calling up their Frax score at the time of a trip to the pharmacy. For many women this may mean medication, but for many it may not.

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Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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