Osteoporosis treatment
Treatment of osteoporosis will vary according to your age, sex, previous medical history and the severity of the osteoporosis. Your doctor can advise on the best treatment so that you have less bone loss and improved mobility and quality of life.
You may be advised to do the following.
- Improve your lifestyle by taking more calcium or supplements of calcium with or without Vitamin D; doing regular weight bearing exercise; not smoking; and avoiding excessive alcohol intake.
- Take hormone replacement therapy (HRT). Your doctor should discuss the potential benefits and any contraindications
- Make your house safe. It is often a fall that causes a fracture. Remove loose mats, power cords and uneven surfaces, if possible. Install night-lights and grab rails where needed. Make sure your eye-glasses prescription is up to date. Sedatives and some drugs used to treat blood pressure may also increase the risk of falling and should only be taken as prescribed by your doctor. Contact the Falls Prevention Unit in your state for further advice.
When is medication for osteoporosis necessary?
If a positive diagnosis of osteoporosis is made after a bone density test, your doctor may suggest you take medication to prevent further bone loss.
There are several treatment options.
Hormone Replacement Therapy (HRT)
Oestrogen (the female hormone) has been shown to stop and partially reverse bone loss and can reduce the risk of osteoporosis in women after menopause and in older women who already have been diagnosed with osteoporosis. HRT has also been shown to have other benefits, such as reducing the risk of heart disease and helping to control menopausal symptoms. Your doctor should discuss the potential benefits and any contraindications.
Calcium
Most people should be able to obtain adequate levels (800 mg to 1000 mg per day) of calcium in their diet. Calcium supplements can be beneficial to those people with existing osteoporosis and as a preventive measure to those who do not have a high calcium intake in their diet. Not all calcium tablets contain enough elemental calcium (or calcium that can be used by your body) so speak to your doctor or pharmacist about making the right choice.
Vitamin D
Vitamin D plays an important role in controlling the entry and loss of calcium from bones. Older people, especially if housebound or institutionalised, may not get enough sunlight exposure and may not make enough Vitamin D.
Special forms of Vitamin D (such as calcitriol) can improve your calcium absorption from the diet and have been shown to reduce the risk of further fracture if you already have osteoporosis.
Bisphosphonates
Bisphosphonates are a non-hormonal type of therapy which stick to the bone surface and make the cells which break down and destroy bone tissue less effective. This allows the bone rebuilding cells to work more efficiently, and has been shown to reduce the risk of further fracture if you already have osteoporosis.
Specific Oestrogen Receptor Modulators (SERMs)
SERMs have been shown to reduce bone loss and increase bone mineral density in post-menopausal women. They also have benefits for the heart and may reduce the risk of breast cancer. They are not HRT and will not relieve menopausal symptoms.
Your doctor will work with you to decide which approaches are best for you. It is important to discuss with your doctor how you should take these medication and any side effects you may experience. Ask lots of questions and remember to read the instructions about these medications.
Last Reviewed: 14 November 2001
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