Prevention of osteoporosis and osteoporotic fractures in postmenopausal women: recommendation statement from the Canadian Task Force on Preventive Health Care

Fig. 1: Recommendations of the Canadian Task Force on Preventive Health Care for the prevention of osteoporotic fractures in postmenopausal women. This algorithm excludes women with secondary osteoporosis (e.g., those who have hyperparathyroidism or are taking steroids). *World Health Organization (WHO) definitions: normal = T score ≥ –1.0; osteopenia = T score < –1.0 and > –2.5; osteoporosis = T score ≤ –2.5, where the T score is the standard deviation above or below the mean bone mineral density for young adults. †Published data have not shown any reduction in clinical fracture in this group of postmenopausal women. ‡Evidence to support the use of these medications is limited to postmenopausal women with osteoporosis and prevalent fractures. §For most postmenopausal women without menopausal symptoms, the risks may outweigh the benefits. ¶These recommendations are not based on fracture data. DEXA = dual energy x-ray absortiometry. SCORE and ORAI are two risk assessment tools (available online). PTH = parathyroid hormone.