Osteoporosis: Only 27–44% of postmenopausal women qualifying for osteoporosis received treatment – half got just calcium + vitamin D

A low number of postmenopausal women receive osteoporosis treatment, regardless of the criteria used to initiate therapy

Journal of Clinical Densitometry (Elsevier / International Society for Clinical Densitometry), Oct 22, 2026 (online ahead of print), https://doi.org/10.1016/j.jocd.2026.101757

Rafał Hebel, Wojciech Pluskiewicz, Piotr Adamczyk, Bogna Drozdzowska

Summary by Claude - November, 2026

Even at specialist osteoporosis clinics, only 27–44% of postmenopausal women who qualified for osteoporosis drugs were actually receiving them. About half were given only calcium plus vitamin D, no matter which fracture-risk criterion was used to decide who needed treatment.

This cross-sectional study (a single snapshot in time) included 508 consecutive postmenopausal women, average age 70, at three osteoporosis outpatient clinics in Poland. The researchers measured hip bone density, collected clinical risk factors, and estimated fracture risk with FRAX and the Polish POL-RISK tool. They then compared six common thresholds for starting drug therapy (FRAX major-fracture risk ≥10% or ≥6.3%, POL-RISK ≥18%, femoral-neck T-score ≤ −2.5, a prior osteoporotic fracture, or T-score ≤ −2.5 plus a prior fracture) with what each woman actually received.

Overall, 13% received no treatment, 52% received only calcium + vitamin D, and 35% received antiresorptive drugs (drugs that slow bone loss). Among women who qualified for therapy, 10–16% were untreated and 46–60% were on supplements only. High-risk women were more often given drugs. FRAX, POL-RISK, and prior fracture were each significantly linked to the treatment decision. A T-score ≤ −2.5, the standard bone-density definition of osteoporosis, was not.

The abstract does not report the vitamin D form, dose, or blood 25(OH)D levels. The authors say the low treatment rate "may contribute to increasing number of osteoporotic fractures."

This summary is based on the Abstract only; the full paper was not available.

What this does NOT show

  • Whether calcium + vitamin D protected these women — no fractures or other outcomes were tracked.
  • Whether drug therapy would have prevented fractures in this group.
  • Why women did not get drugs (patient choice, side-effect worries, cost, or doctors' judgment) — the abstract gives no reasons.
  • Whether the vitamin D dose was adequate, since dose and 25(OH)D levels are not reported.
  • How well the findings apply beyond three Polish specialist clinics.
  • Conflict of interest: the first author is an employee of Egis Polska, a pharmaceutical company, and received employer support to obtain and process the data. The authors state the sponsor had no role in the study.

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