North American Menopause Society Releases Updated Osteoporosis Guidance


The organization's first update since their 2010 position statement, the osteoporosis position statement reflects more than a decade of advances in knowledge related to diagnosis and management of osteoporosis.

An illustration of porous bone structure

The North American Menopause Society (NAMS) has released a new position statement outlining the organization’s guidance for the management of osteoporosis in postmenopausal women.

With their most recent position statement released more than a decade prior in 2010, the latest update reflects advances in management and assessment tools as well as providing guidance related to role of nutrition in maintaining bone health in postmenopausal women.

“Education regarding a woman’s skeletal health risks is critical during the menopause transition. The recommendations made in the updated position statement include strategies designed to minimize bone loss as a way to prevent fractures and help women maintain mobility and independence,” said Michael McClung, a member of the NAMS board and co-lead of the Editorial Panel for the 2021 Osteoporosis Position Statement and founding director of the Oregon Osteoporosis Center in Portland, Oregon, in a statement.

A 25-page document with 225 references, the position statement was composed by a 6-person editorial panel led by McClung and JoAnn Pinkerton, MD, division director of Midlife Health with the University of Virginia Health System, who were tasked with reviewing and updating the 2010 statement as well as reviewing new evidence for inclusion. To mold the current position statement, the panel reviewed studies published in English related to osteoporosis management in postmenopausal women, with priority given to randomized clinical trials and meta-analyses of these trials. The statement authors noted the focus of their review, in regard to therapies, was listed to those available for use in North America.

Much of the document, which was published on September 1, highlights known risk factors and underscores the importance of education related to osteoporosis for both clinicians and patients. Highlights of the new statement include the endorsement of hormone therapy for preventing bone loss at the time of menopause for healthy women, particularly those with menopause symptoms.

Additionally, the latest statement recommends use of T-score at the hip as an appropriate target for guiding therapy choices as current evidence suggests bone mineral density measured on-treatment correlates with the patient’s risk of fracture. The statement also outlines differing treatment approaches for women at very high risk of fracture, which calls for beginning treatment with a bone-building agent following by an antiremodeling agent, such as bisphosphonates and denosumab.

“This new position statement on osteoporosis provides clinicians with a practical guide to assessing and managing bone health in postmenopausal women and emphasizes an individualized approach with regular follow-up and adjustment based on changing clinical needs and patient preference,” said Stephanie Faubion, MD, MBA, NAMS medical director, in a statement.

This statement, “Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society,” was published in Menopause: The Journal of The North American Menopause Society.

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