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Paraplegic with Osteoperosis
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Megte posted:
Hi.

I am a 40 year old pre-menopausal newer mom (16 mnoth old) that has just been diagnosed with osteoperosis. My spine is ok. My hips and legs are bad.

My doctor has put me on 1000 mg of D3 and 2400 mg of calcium (ex strength Tums) per day. He also suggested I start on Boniva.

Everything I have read on Boniva and the like drugs are for post menapausal women. Are they ok for pre as well? Are there any for pre men women? I don't want to be a guinea pig.

What are my options??

thanks
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bonebabe responded:
There are no medications currently approved for premenopausal women. I'm curious about your diagnosis of diagnosis at this time. Are you nursing? Pregnancy and nursing can deplete the bone mass, but it usually regains that loss when nursing stops. Has he done any tests on you to determine the cause of the bone loss? Osteoporosis in premenopausal woman is often secondary to something else going on.

The Vit D recommendation is currently 1000 IU per day, so you're right on target there. I would ask to have my levels checked at your next appointment though. It may be that you need a prescription booster dose. The 2400 mg of calcium seems somewhat high unless there's something else going on. Because the body can only absorb 500-600 mg at a time, actually getting 2400 can be difficult. The recommendation is about 1000-1200 mg per day.

Talk to your doctor a little more or talk to another doctor - maybe your ob/gyn now that you have some more information. Also you can research this on the National Osteo Foundation website (www.nof.org ) for a lot of reliable info.
 
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NATIONAL OSTEOPOROSIS FOUNDATION
Adi Cohen, MD, MHS responded:
Evaluation of bone health in a young woman should take into account reproductive history since pregnancy and lactation both have effects on bone metabolism and bone density. Because of the calcium demands of milk production, breastfeeding is associated with an expected, reversible loss of bone. Recovery of bone density has been shown beginning 6-12 months postpartum and may continue for months thereafter. Bone density tests done in the context of breastfeeding or soon after weaning should be interpreted with these expected changes in mind, since improvement in bone density may be expected in the future. All women who are
pregnant or nursing need to get enough calcium, vitamin D and appropriate exercise to keep their bones healthy (see www.nof.org for NOF's recommendations).

Decisions about treatment for osteoporosis in a premenopausal woman must be made on an individualized basis that takes into account risks of fracture and bone loss, as well as potential risks and side effects of the medications. There is less information available about treatment options for premenopausal women than for postmenopausal women with osteoporosis, because the condition is uncommon. In general, medications for osteoporosis should be used with caution in premenopausal women because less information is known about how they will affect young women in the short and long term.

A further discussion might be found in:
Should bisphosphonates be used in premenopausal women? Cohen A. Maturitas. 2010 May;66(1):3-4. Epub 2010 Mar 30.


Helpful Tips

Bisphosphonate use in premenopausal womenExpert
The potential benefits and risks of bisphosphonate use may be quite different in premenopausal women compared to postmenopausal women. ... More
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