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Do. Dr. Gazi YILDIRIM Yeditepe niversitesi Hastanesi Kadn Hastalklar ve Doum AD

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Reproductive Aging Process begins in embryonic life. 20 weeks gestation - 6 - 7 million follicles. At birth - 1.5-2 million follicles At menarche - 300,000- 400,000 follicles Follicular atresia continues throughout life. Follicular loss accelerates when the total number of follicles is ~25,000 When follicles are sufficiently depleted (

prevention of postmenopausal osteoporosis PRIMARY PREVENTION 1. HRT 2. SERMS 3. TIBOLONE 4. Biophosphonate SECONDARY PREVENTION 1. Biophosphonates 2. Calcitonin (>5 yrs menopause) 3. Teriparatide 46

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Bisphosphonates Promotes bone formation and decreases bone resorption Mechanism of Action First line treatment for osteoporosis in both men and post- menopausal women 1 Application Approved in both sexes for the prevention and treatment of osteoporosis Aledronate 2, Risedronate 3 and Zoledronic Acid 4

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DrugVertebral Fracture RR Hip Fracture RR Non- vertebral RR Route/ Frequency Indicated for which gender AlendronatePO/QDay, QWeek Women Men RisedronatePO/QDay, QWeek, QMonth Women Men IbandronateNE PO/QMonth IV/Q3Mont h Women Zoledronic Acid IV/QYearWomen Men RR = Risk ReductionNE = No effect demonstrated Bisphosphonates