2026 Urogynecology for the Advanced Practice Provider-Endocrine Considerations in Postmenopausal Women Inlcuding Thyroid, Osteoporosis, and MHT

Video Transcription

Video Summary

The speaker reviewed thyroid screening and osteoporosis management in postmenopausal women. Key points: thyroid disease is not screened in asymptomatic people, but TSH testing is recommended in symptomatic or high-risk patients, including those with autoimmune disease, family history, prior radiation, Down/Turner syndrome, or medications like amiodarone, lithium, and immune checkpoint inhibitors. Thyroid disorders can accelerate bone loss, especially hyperthyroidism, which increases fracture risk.<br /><br />For osteoporosis, the talk covered when to order early DEXA scans, how to interpret T-scores and FRAX, and the importance of calcium and vitamin D. First-line treatment remains bisphosphonates, with counseling on side effects, kidney limitations, and rare risks like osteonecrosis of the jaw and atypical femur fracture. Other therapies included denosumab, anabolic agents such as teriparatide and abaloparatide, romosozumab, raloxifene, and menopausal hormone therapy.<br /><br />Menopausal hormone therapy can help prevent bone loss in appropriate patients, especially women under 60 or within 10 years of menopause. The speaker also discussed a 2025 Cochrane review suggesting therapy effects depend on the formulation and patient age, with older trial data showing some cardiovascular and cancer risks. The session ended with discussion of bisphosphonate drug holidays and early bone screening in patients with premature menopause or strong family history.

Asset Subtitle

Attendees will gain insights into optimizing endocrine care to improve quality of life and reduce long-term health risks in postmenopausal women. This talk explores evidence-based approaches to hormone therapy for symptom relief and bone preservation.

Learning Objectives:

Know current recommendations for thyroid screening and management in this demographic.
Appreciate the accelerated bone loss associated with hyperthyroidism and estrogen deficiency.
Discuss the role of calcium, vitamin D, and pharmacologic therapies including bisphosphonates.
Understand when and how menopausal hormone therapy can be used to prevent osteoporosis.

Speaker: Jenna Sarvaideo, DO

Keywords

thyroid screening

postmenopausal osteoporosis

TSH testing

DEXA scan

bisphosphonates

menopausal hormone therapy

bone loss