Monday Memo  

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Monday, June 25, 2012
  Clinical Accuracy Spoken Here  

Menopausal Bone Loss

In the United States, some 8 million women have osteoporosis, 22 million women have osteopenia, and an inestimable number of women are at risk.

Indeed, more than one-half of Caucasian women have clinically significant bone loss by the end of the first postmenopausal decade.

The risk of a 50 year old Caucasian woman sustaining an osteoporotic fracture during her lifetime is 40%, similar in magnitude to succumbing to heart disease.

[Reference: Women's Health, Module B, Complications]

  Excellence in Case Mgmt  

Erratic Hormones = Erratic Glycemic Control

Perimenopause is a time of erratic hormone production. This variability in endogenous hormones can result in erratic and varied glycemic control despite a closely monitored dietary intake. Women (and their healthcare providers) can often be mystified by the seeming incongruence in glucose levels.

Following menopause, pancreatic insulin secretion decreases and insulin resistance increases. These changes may be related to aging and a decrease in estrogen production.

The Case Manager can play an important role in educating patients to conduct self-monitoring blood glucose testing and to have additional screenings done by their physician.

[Reference: Women's Health, Module D, CM Role]

  Improving Patient Care...  

Is GP Screening for Menopause?

As case managers interact with women either at risk for heart disease, or who may currently have a CVD, the additional concurrent physical changes being experienced by the patient must be taken into account.

A large percentage of women are not interviewed by their general practitioner regarding their sexual or menstrual history. The assumption often is female patients have gynecologists with whom the subject is discussed.

When gathering a patient's history keep in mind that women may not offer a menstrual history as part of their 'medical' background.

[Reference: Women's Health, Module D, CM Role]


Tom RasmussenTom Rasmussen
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