Treatment for women:
The treatment goals for osteoporosis are to stop continued bone loss or slow it down as much as possible and to prevent bone fractures. Breaking a bone is painful and debilitating. It may mean a hospital stay, long-term disability and the loss of independence. Osteoporotic (thinned and weakened) vertebral bones may collapse under the weight of the spinal column, causing what is known as a crush or compression fracture. This is generally very painful and can lead to an abnormal curvature of the spine, disfigurement and disability.
If you have osteoporosis, your doctor may recommend as part of your treatment:
Osteoporosis does not have a cure, but can be managed through medication, exercise and lifestyle. Drugs approved by the U.S. Food and Drug Administration (FDA) for treating the disorder can preserve or increase bone density and maintain bone quality. However, if you stop taking one of these drugs, your bones will again begin to lose density and become thinner.
Here are medications that your doctor may recommend. All drugs can cause side effects. Your doctor can give you more information about the potential risks and benefits of drug therapy for osteoporosis. The medications include:
Teriparatide (Forteo), a synthetic form of a natural human hormone called parathyroid hormone, is the first osteoporosis medication to increase the rate of bone formation in the bone remodeling cycle. The drug forms new bone, increases bone mineral density and bone strength. Teriparatide can be taken by men or postmenopausal women with osteoporosis. The drug can be used by people who have had an osteoporosis-related fracture or who cannot use other osteoporosis treatments. Side effects include nausea, leg cramps and dizziness.
Medications that help slow the resorptive phase of the bone-remodeling cycle are:
Bisphosphonates
Bisphosphonates, such as alendronate (Fosamax), ibandronate (Boniva) and risedronate (Actonel), prevent and treat postmenopausal women by reducing bone loss, increasing bone density and reducing the risk of fractures. Side effects are not common but may include abdominal pain, nausea, heartburn or irritation of the esophagus, the tube leading to your stomach. The FDA warns that people taking these drugs may have severe muscle and bone pain that can occur within days, months, or years after starting the medication. Tell your doctor about pain or other side effects.
Calcitonin
This is a naturally occurring hormone. Miacalcin and Calcimar are two synthetic forms of calcitonin that help slows bone loss, increase spinal bone density and may relieve pain from bone fractures. Calcitonin reduces the risk of spinal fractures but may not decrease the risk of other fractures. Calcitonin can be taken as an injection or nasal spray. The injectable form may cause an allergic reaction and side effects including flushing of the face and hands, urinating more often, nausea, and a skin rash. Side effects for the nasal version are not common but may include nasal irritation, back pain, bloody nose and headaches.
Selective estrogen receptor modulators (SERMs)
Raloxifene (Evista) prevents and treats postmenopausal osteoporosis. SERMs have the helpful effects of estrogen therapy without the potential disadvantages. Raloxifene increases bone mass and reduces the risk of spine fractures. Side effects are not common but may include hot flashes and deep vein thrombosis (a blood clot starting in the legs).
Note that hormone replacement therapy (HRT) was once recommended as a treatment to prevent osteoporosis, but that is no longer advised due to risks now known about taking HRT.
Treatment for men:
More study is needed to establish the best way to treat men who are diagnosed with osteoporosis. If a man has low testosterone levels, doctors are likely to prescribe testosterone replacement to correct the problem and to prevent further bone loss. Whether this step can reverse bone loss is unknown. Smoking and alcohol use increase the risk of bone loss. Other steps that may be recommended by doctors include increased dietary calcium, calcium supplements and multivitamins, and increased exercise.
The use of drug therapy has not been studied in men as extensively as in women, but bisphosphonates have been shown to slow down bone loss. Your doctor may prescribe alendronate or residronate , shown to be helpful for men with osteoporosis. Another drug called Teriparatide may also be prescribed for men who are at increased risk for fractures.
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