The absolute amount of bone as measured by bone mineral density (BMD) testing generally correlates with bone strength and its ability to bear weight. The BMD is measured with a dual energy x-ray absorptiometry test (referred to as a DXA scan). By measuring BMD, it is possible to predict fracture risk in the same manner that measuring blood pressure can help predict the risk of stroke.

It is important to remember that BMD cannot predict the certainty of developing a fracture. It can only predict risk. It is important to note that a bone density scan, or test, should not be confused with a bone scan, which is a nuclear medicine test that is used to detect tumors, cancer, fractures, and infections in the bone.

The World Health Organization is the source of the commonly-accepted definitions for osteoporosis (WHO Technical Report Series #843, Geneva 1994):

Normal: A value for BMD statistically within 1 standard deviation of the young adult peak bone mass. The report shows a T score > -1 signifying a BMD within the normal range.

Low bone mass (medically termed osteopenia): A value for BMD statistically less than 1 standard deviation but more than 2.5 standard deviations below that of an average young adult. The report shows a T score between -2.5 and Â£ -1, which signifies an increased fracture risk but does not meet the criteria for osteoporosis.

Osteoporosis: A value for BMD statistically more than 2.5 standard deviations below that of the average peak young adult bone mass. BMD in this range signifies an even higher fracture risk than osteopenia. The report shows a T score Â£-2.5.

Based on the above criteria, it is estimated that 40% of all postmenopausal Caucasian women have osteopenia and that an additional 7% have osteoporosis (Siris et al JAMA 2001).

WebMD Medical Reference

Reviewed by Jonathan L Gelfand, MD on February 11, 2008

Osteoporosis Guide

Overview & Facts

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Diagnosis & Tests

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Living & Managing

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As You Journey through Menopause, Vivelle-Dot Is By Your Side

VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.

INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information for Vivelle-Dot.

Prescribing Information