The age of peak bone mineral accrual occurs about one year later. This represents as much bone mineral as most adults will lose in their lifetime. This period represents a period of tremendous opportunity to optimize peak bone mass but also represents a period of terrible vulnerability to insult. Development of normal bone mass is also dependent on normal pubertal maturation. The assessment of bone mineral content is considerably more challenging in children than in adults because of changes in bone size and geometry during skeletal growth.
Osteoporosis refers to reduced bone mass, disruption of bone architecture and fragility fractures.
In the premenopausal woman, if the only osteoporosis risk factor is being female, general education efforts directed at optimal calcium intake and exercise should be given to each patient. In the premenopausal woman, where there is concern about osteoporosis because of historical or lifestyle risk factors, or past or new fractures a BMD test may be obtained. Discussions about changing and improving lifestyle risk factors and education about optimal calcium intake and exercise should be undertaken. Retest in 2 to 5 years. Repeat BMD in 2 years.