An excellent story on NPR suggests that millions of American women may have been taking a drug unnecessarily. The drug Fosamax is manufactured by Merck, a huge pharmaceutical company. The drug is approved by the FDA to treat osteoporosis, which is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture. The problem is that Merck developed a Bone Density test that resulted in women having a much less serious condition called osteopenia appearing to require the drugs to treat osteoporosis. As a result millions of women with osteopenia were prescribed serious and expensive drugs that they did not need. osteopenia occurs more frequently in post-menopausal women as a result of the loss of estrogen. It can also be exacerbated by lifestyle factors such as lack of exercise, excess consumption of alcohol, smoking or prolonged use of glucocorticoid medications such as those prescribed for asthma. Women with osteopenia do not require medication.