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When you have osteoporosis, it is especially important to protect yourself from falling. When bones lose mass and become more brittle, they lose strength and break more easily. Women of European and Asian ancestry are more likely to have osteoporosis than those with African ancestry. An estimated 17% of white women will break a hip sometime after age 50, as will 6% of white men. ¹⁴ To reduce your chances of breaking bones, take steps to prevent falls, such as having your vision and hearing checked regularly and wearing slippers or shoes with a nonskid sole. Exercises that improve balance and coordination, such as tai chi, can also reduce your risk of falling.

If your tests indicate continuing bone loss, your doctor likely will recommend that you take medicine to increase bone density and decrease your risk of spine and hip fractures. These medicines include bisphosphonates, such as risedronate (Actonel) or alendronate (Fosamax). It's important to take calcium and vitamin D supplements along with any medicines you take for osteoporosis. For more information about taking bisphosphonates, see:

Should I take bisphosphonate medicines for osteoporosis?

Calcitonin may be prescribed for women who are more than 5 years beyond menopause and who cannot take bisphosphonate medicines, or for men who are not receiving testosterone treatment. Calcitonin has the added advantage of helping reduce pain from spinal fractures. But studies show that calcitonin is less effective than bisphosphonate medicines at stopping bone loss. ¹⁵

Raloxifene (Evista) may be prescribed for women, especially if you are 55 to 65 years old. Raloxifene has been proved to reduce the risk of spinal fractures but not hip fractures. ¹⁶ Raloxifene may also reduce the risk of breast cancer, although it is not approved for this purpose. Raloxifene can cause hot flashes, so it is not often used in early menopause (45 to 55 years) when hot flashes are frequent.

In some cases, hormone replacement therapy (HRT) or estrogen replacement therapy (ERT) is given to women to slow bone loss from osteoporosis. But hormone therapy can also increase the risk of other conditions, including stroke and breast cancer. Many experts recommend that long-term hormone replacement therapy only be considered for women with a significant risk of osteoporosis that outweighs the risks of taking HRT or ERT.

Treatment if the condition gets worse

It is never too late to build and then keep healthy habits that can slow bone thinning.

• Eat a nutritious diet that includes adequate amounts of calcium and vitamin D. Both are necessary for building healthy, strong bones. Take supplements if you think you are not getting enough of these nutrients in your diet. Recommendations vary, but the National Osteoporosis Foundation suggests that adults up to age 50 get 1,000 mg of calcium and 400 to 800 IU of vitamin D a day. If you are age 50 or older, the recommended amounts are 1,200 mg of calcium and 800 to 1,000 IU a day of vitamin D. Your bones need vitamin D to absorb calcium. One study showed that vitamin D may reduce an older person's risk of falling by 22%. ⁹ The best source of vitamin D is exposure to sunlight. Vitamin D is also added to milk, some calcium supplements, and many multivitamin supplements.
• Get regular exercise. Weight-bearing exercises, such as walking, jogging, stair climbing, dancing, or lifting weights, keep bones healthy by working the muscles and bones against gravity.