Gerald N. Grob,Aging Bones: A Short History of Osteoporosis

In Aging Bones medical historian Gerald N. Grob expounds his thesis about osteoporosis that the ‘normal aging of bones was transformed into a medical diagnosis that eventually included every aged person’ (p. xv). This transformation occurred through a coalition of cultural, medical and pharmaceutical forces that moved osteoporosis from the margins of health research in the earlier part of the twentieth century to the centre of a national and well-funded American agenda by the twenty-first century, that urged all women over 65 (and men over 70) to be screened for bone mass density (BMD). But why osteoporosis? We already know that as we age our bones change and can become more fragile. We also know that menopause can affect bone strength. However, osteoporosis, as Grob explains, was elevated to a master deficiency linked to bone fractures and falls because of its relentless targeting by the powerful industries that produced oestrogen hormone replacement therapy (HRT) and screening machines. While calcium supplements, Vitamin D and bisphosphonates such as Merck's Alendronate also became profitable items in the armamentarium for osteoporosis, nothing has topped premarin-based HRT as the recommended treatment since the 1980s.