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Frauenheilkunde up2date 2016; 10(03): 203-218
DOI: 10.1055/s-0042-108054
Gynäkologische Endokrinologie und Reproduktionsmedizin
Georg Thieme Verlag KG Stuttgart · New York

Osteoporose in der Gynäkologie – Diagnostik und Therapie

Heide Siggelkow
,
Peyman Hadji
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Publication Date:
22 June 2016 (online)

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Kernaussagen

  • Jede prämenopausale amenorrhoische Frau hat prinzipiell ein Risiko für eine Fraktur.

  • Besonders hoch ist das Risiko nach Chemotherapie, unter Aromataseinhibitor- oder GnRH-Therapie ± Tamoxifen.

  • Eine Knochendichtemessung mittels DXA-Methode ist individuell indiziert, aber nur bei einem erhöhten Gesamtfrakturrisiko > 20 % eine Kassenleistung.

  • Im Vordergrund steht auf jeden Fall die Minimierung von Risikofaktoren.

  • Je nach Alter, Knochendichtemessung und Risikofaktoren ist eine spezifische Therapie indiziert.

  • 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.

  • 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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