- Hormone Replacement Therapy
- Bisphosphonates - Fosamax (alendronate) and Actonel (risedronate sodium)
- Evista (raloxifene)
- Fosamax (alendronate)
- Miacalcin (calcitonin)
- Percutaneous Vertebroplasty
- Experimental Treatments
- Monitoring the Treatment of Osteoporosis with Bone Densitometry
- Additional Lifestyle Changes
- Additional Resources and References
Preventing osteoporosis by maintaining a health diet rich in calcium and vitamin D and exercising regularly can help many women avoid the serious effects of osteoporosis. Women who have low bone mineral density or osteoporosis may also benefit from taking hormone replacement therapy or other drug therapies. This section describes treatments for osteoporosis.
Hormone replacement therapy (HRT) is synthetic estrogen and/or progesterone (called progestin). Past research has shown that that has been shown to be effective in treating osteoporosis. However, recent research has found that HRT may not provide these benefits and may pose other risks, including an increased risk of ovarian cancer (with long-term use) and cancer of the uterine lining (in women do not take progestin with estrogen).
HRT is designed to "replace" a woman's depleting hormone levels at menopause. HRT is commonly prescribed to help relieve menopausal symptoms, such as hot flashes and vaginal dryness. HRT is thought to be most effective against osteoporosis if taken during the first five years after menopause begins.
Because of the risks associated with HRT, women should talk with their physicians about whether HRT is an appropriate treatment option for osteoporosis, and may wish to consider alternative treatments.
The drugs, Fosamax (generic name, alendronate) and Actonel (generic name, risedronate sodium), belongs to a group of drugs called bisphosphonates. They are commonly used to prevent and treat osteoporosis in post-menopausal women. Fosamax and Actonel are not estrogens and do not carry the associated risks or benefits of estrogen (see the hormone replacement therapy section above).
Studies show that after three years of use, Fosamax can reduce the risk of hip fractures in patients with a history of vertebral fracture by 51%. Actonel can reverse bone loss and help reduce the risk of bone fractures by halting further loss of bone and increasing bone mass. Actonel is not an estrogen and does not carry the associated risks or benefits of estrogen Recent research shows that Fosamax may be combined with hormone replacement therapy (HRT), and in fact, when used in combination, patients may receive increased protection from fractures. However, HRT does carry some risks (see the hormone replacement therapy section above). Also, the long-term use of combination Fosamax and HRT has not been assessed.
Fosamax and Actonel should be taken first thing in the morning in an upright position (sitting or standing) with six to eight ounces of plain water. Patients should not eat or drink anything besides plain water with the medicines, and they should not lie down within 30 minutes of taking the medicines. Calcium, vitamin D, or other supplements should be taken at a separate time.
Side effects of bisphosponates include:
- Abdominal or musculoskeletal pain
- Irritation of the esophagus
More information on Fosamax, courtesy of Merck and Company, Inc.
More information on Actonel, courtesy Proctor and Gamble.
Evista (generic name, raloxifene) belongs to a group of drugs called SERMs (selective estrogen-receptor modulators) and is prescribed to help prevent and treat osteoporosis. Evista helps build new bone and reduces the risk of fractures. In several studies, Evista has reduced the risk of bone fractures by 50%. Most post-menopausal women who take Evista are prescribed one pill a day (60 milligrams). Physicians recommend that women take calcium and vitamin D supplements in addition to Evista to further reduce the risk of fractures.
As with every drug, Evista has a range of possible side effects, both positive and negative. One positive effect of Evista is that is has been shown to reduce LDL ("bad") cholesterol and total cholesterol levels, which can decrease a womanâ€™s risk of heart disease. Studies are also investigating whether Evista may also help prevent breast cancer in women at high risk for the disease.
As with every drug, Evista has a range of possible side effects, both positive and negative. One positive effect of Evista is that is has been shown to reduce LDL ("bad") cholesterol and total cholesterol levels, which can decrease a woman's risk of heart disease.
Common side effects of Evista may include:
- hot flashes
- leg cramps
- swelling of the legs and feet
- flu-like symptoms
- joint pain
Evista can also increase the risk of deep vein thrombosis (blood clots in the deep veins of the leg) and pulmonary embolism (blood clots in the lungs). Women who have a history of blood clots should not take Evista.
More information on Evista, courtesy of Eli Lilly and Company.
Fosamax (generic name, alendronate) belongs to a group of drugs called bisphosphonates and is commonly used to prevent and treat osteoporosis in post-menopausal women. Fosamax has been shown to strengthen bones and reduce hip and spinal fractures. Studies show that after three years of use, Fosamax can reduce the risk of hip fractures in patients with a history of vertebral fracture by 51%. Recent research shows that Fosamax may be combined with hormone replacement therapy (HRT), and in fact, when used in combination, patients may receive increased protection from fractures. However, the long-term use of combination Fosamax and HRT has not been assessed.
Side effects of Fosamax may include:
- Abdominal pain
- Constipation and diarrhea
- Muscle or joint pain
In addition, some patients who take Fosamax develop severe digestive reactions including irritation, inflammation or ulceration of the esophagus. These reactions can cause chest pain, heartburn or difficulty or pain upon swallowing. The risk of severe esophageal adverse reactions appears to be greater in patients who lie down immediately after taking Fosamax and/or those who fail to take Fosamax with a full glass of water. Patients should not take Fosamax if they have certain disorders of the esophagus, they cannot stand or sit upright for at least 30 minutes, they have low levels of calcium in their blood, or they have severe kidney disease. Fosamax is available in once daily or once weekly regimens.
More information on Fosamax, courtesy of Merck and Company, Inc.