Primary hyperparathyroidism in women: Medical and surgical treatments

Primary hyperparathyroidism (HPT) occurs in 2% of people over the age of 55. Women are affected two to three times more often then men. Postmenopausal women are at the greatest risk. The advent of the multichannel, routine screening of serum chemistries in the 1970s led to a dramatic increase in the detection of hypercalcemia and the diagnosis of underlying HPT. The recognition of HPT and its evolving clinical presentation has also been influenced by greater attention devoted over the last two decades to the screening for bone disease. Chronic parathyroid hormone excess stimulates bone remodeling and ultimately activates osteoclast-mediated destruction of bone. Medical treatment options are evolving for osteoporosis in HPT. Treatments that may improve bone density in HPT include bisphosphonates, estrogen, selective estrogen receptor modulators, and surgery.