Osteoporosis Treatments

Because osteoporosis is difficult to reverse, prevention is the key to treatment.

Calcium is the cornerstone of treatment. To help with the absorption of the calcium, vitamin D supplements should also be taken. A regular exercise program -- including weight-bearing exercises, such as walking and aerobics -- can help keep your bones stay strong and free of fractures.

Menopausal hormone replacement therapy -- either estrogen alone or a combination of estrogen and progestin -- was used for prevention and treatment of osteoporosis. However, in July 2002, a landmark study revealed that hormone therapy increases the risk of breast cancer, heart disease, and stroke in some women. Hormone replacement therapy is known to help preserve bone and prevent fractures, but is not generally recommended at this point for osteoporosis because the risks are thought to outweigh the benefits.

In women who have been on hormone replacement therapy in the past and then stopped it, the bone begins to thin again -- at the same pace as during menopause.

Evista is an osteoporosis drug that has some actions similar to estrogen, such as the ability to maintain bone mass. However, studies have shown that it doesn't increase the risk of breast or uterine cancers like estrogen. Evista can cause blood clots and often increases hot flashes.

Actonel, Boniva, and Fosamax (also available as generic) treat osteoporosis by inhibiting cells that break down bone and slowing bone loss. Actonel and Fosamax are usually taken once a week while Boniva is taken once a month. There are strict ways to take these medications, since if taken incorrectly, they can lead to ulcers in the esophagus.

Another new osteoporosis medication is Reclast, which is given as a once-yearly 15-minute infusion in a vein. Reclast is said to increase bone strength and reduce fractures in the hip, spine and wrist, arm, leg, or rib.

Forteo is a new medication used for the treatment of osteoporosis in postmenopausal women and men who are at high risk for a fracture. A synthetic form of the naturally occurring parathyroid hormone, Forteo is the first drug shown to stimulate new bone formation and increase bone mineral density. It is self-administered as a daily injection for up to 24 months. Side effects include nausea, leg cramps, and dizziness.

Calcitonin is another treatment option for osteoporosis. Calcitonin is a naturally occurring hormone that inhibits bone loss. It is available as a nasal spray or injection and is quite expensive. Undesirable side effects include nausea and skin rashes.

Osteoporosis Prevention Through Nutrition and Diet

To ensure that people are getting enough calcium to build and maintain strong bones, doctors recommend eating plenty of calcium-rich foods, such as nonfat milk, low-fat yogurt, broccoli, cauliflower, salmon, tofu, and leafy green vegetables.

According to a panel convened by the National Institutes of Health, women who are still menstruating, or who are postmenopausal but taking hormone replacement therapy, should get 1,000 mg of calcium each day. This jumps to 1,200 to 1,500 mg per day for pregnant or breastfeeding women. Postmenopausal women not on hormone replacement therapy should get 1,500 mg/day.