Health A-Z

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Treatment

Doctors initially treat osteoporosis by:

  • Making sure the person gets enough calcium daily and prescribing calcium if dietary sources are not adequate

  • Prescribing vitamin D

  • Recommending weight-bearing exercises

  • Modifying other risk factors

Medications

For women, many medications are available to treat osteoporosis. These include:

  • Bisphosphonates. These are the drugs used most often to treat osteoporosis in postmenopausal women. Bisphosphonates inhibit the breakdown of bone. They may even increase bone density. Most are taken as a tablet, by mouth. But some may be given intravenously.

Bisphosphonates can cause side effects. These include nausea, abdominal pain, irritation of the esophagus and difficulty swallowing. One rare but serious side effect is death of the jawbone caused by poor blood supply.

Bisphosphonates include:

    • Alendronate (Fosamax)

    • Risedronate (Actonel)

    • Ibandronate (Boniva)

    • Pamidronate (Aredia)

    • Zoledronic acid (Reclast, Zometa).

  • Selective estrogen receptor modulators (SERMs). SERM s treat osteoporosis by mimicking the effects of estrogen to increase bone density.

    • Raloxifene (Evista)

  • Calcitonin (Miacalcin). Calcitonin is a hormone produced by the thyroid gland. It is given as a nasal spray. Calcitonin inhibits bone breakdown.

  • Teriparatide (Forteo). Teriparatide is a form of parathyroid hormone. It stimulates the growth of new bone. Teriparatide is given by a daily injection. It is not yet recommended for long-term therapy.

  • Denosumab (Prolia). Denosumab is a type of biological therapy. It is an antibody that targets a protein involved in bone breakdown. By attacking this protein, it helps stop bone loss.

  • Estrogen replacement therapy. Rarely recommended because of associated risks. Replaces estrogen lost during menopause. Estrogen slows the breakdown of bone.

Long-term estrogen therapy has been associated with many risks. These include an increased risk of heart disease, stroke, breast cancer and gallstones. Estrogen replacement therapy is rarely used to prevent or treat osteoporosis.

Among men, a low level of testosterone is the most common cause of osteoporosis (other than aging). Testing can reveal if testosterone levels are low. In this case, other tests will look for the cause so that treatment can be started. Men also can use alendronate and raloxifene.

Your doctor will monitor how well your treatment is working. He or she will do this by taking bone density measurements every one to two years.

Treating fractures

If a person with osteoporosis fractures a hip, surgery may be needed. Surgery will realign and stabilize the hip.

A wrist fracture may heal well simply by being put in a cast. Sometimes surgery may be needed to restore proper alignment of the bones.

Other treatments for fracture include pain medication and rest for a short time.

Calcitonin injections may reduce spine pain from a new compression fracture.

Page 6 of 9     Next Page:  Osteoporosis When to Call A Doctor
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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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