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DOI: 10.1055/s-0042-108054
Osteoporose in der Gynäkologie – Diagnostik und Therapie
Publication History
Publication Date:
22 June 2016 (online)
![](https://www.thieme-connect.de/media/frauenheilkunde-u2d/201603/lookinside/thumbnails/10-1055-s-0042-108054_fr_929204_siggelkow-1.jpg)
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Jede prämenopausale amenorrhoische Frau hat prinzipiell ein Risiko für eine Fraktur.
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Besonders hoch ist das Risiko nach Chemotherapie, unter Aromataseinhibitor- oder GnRH-Therapie ± Tamoxifen.
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Eine Knochendichtemessung mittels DXA-Methode ist individuell indiziert, aber nur bei einem erhöhten Gesamtfrakturrisiko > 20 % eine Kassenleistung.
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Im Vordergrund steht auf jeden Fall die Minimierung von Risikofaktoren.
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Je nach Alter, Knochendichtemessung und Risikofaktoren ist eine spezifische Therapie indiziert.
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Bei Schwangeren mit akut aufgetretenen Rückenschmerzen (insbesondere bei Größenabnahme, starken lokalisierten Schmerzen und bei fortgesetzten Beschwerden) sollte auf das mögliche Auftreten von Frakturen geachtet werden.
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Bei Frauen mit einer Anorexie sollte v. a. eine ernährungsbedingte Gewichtszunahme erfolgen. Zusätzlich scheint eine Therapie mit 17-β-Östradiol die Knochendichte zu erhalten.
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