Propensity of gynaecologists towards osteoporosis management and treatment

Background: Regulation authorities have recently advised against the use of hormone replacement therapy (HRT) as a first choice treatment for postmenopausal osteoporosis, modifying the past consensus. Aim: Analyse the sensibility to and prescription attitude for osteoporosis. Setting: Survey. Population: Belgian gynaecologists. Methods: Case construction: two cases to assess whether gynaecologists are prone to detect osteoporosis, and six others to evaluate their prescription attitude for osteoporosis. Results: About 80% of the physicians would prescribe a bone mineral density measurement (BMD) to a 66-year-old, non HRT user. About 60% prescribed calcium and Vitamin D when the BMD was normal, 90% would prescribe it when the BMD showed osteopenia or osteoporosis (p < 0.001). Few prescribed HRT (<25%). Few advised SERMS for normal BMD, 19%–47% prescribed it in osteopenia or osteoporosis (p < 0.001). Few considered a biphosphonate in normal BMD, or osteopenia in the absence of risk factors, 25% considered it in osteopenia in the presence of risk factors, and 80% in osteoporosis (p < 0.001). Conclusion: Most gynaecologists are aware of the osteoporosis problem. They often screen non HRT users and in the event of osteoporosis, they initiate a specific treatment, not HRT, but generally a combination of calcium, Vitamin D and biphosphonates. © 2005 Elsevier Ireland Ltd. All rights reserved.