Osteoporosis and Menopause
Should I Consider Hormone Therapy?
Hormone therapy [estrogen] is believed to be useful in preventing or alleviating the increased rate of bone loss that leads to osteoporosis. It is generally recommended for postmenopausal women who:
- Undergo an early menopause.
- Have a low bone mass, as measured by a bone density test and/or symptoms of menopause.
- Have several other risk factors for osteoporosis, such as: a petite, thin frame; family history of osteoporosis; or a medical problem associated with osteoporosis.
- While all of the risks associated with hormone therapy are not yet known, studies have shown that some types may increase your risk of developing:
- Breast cancer
- Gallbladder disease
- Blood clots
- Heart disease (recent studies suggest this may be more relevant to women of advanced age).
If you are using hormone therapy only for osteoporosis prevention, be sure to talk to your doctor so you can weigh the benefits of hormone therapy against your personal risk and consider other medications for your bones. If needed, your doctor can prescribe different treatments to help prevent osteoporosis.
Is There a Safe Alternative to Hormone Therapy?
For those women who cannot take hormone therapy for health reasons or choose not to because of personal reasons, there are alternatives, including:
- Bisphosphonates. This group of medications includes the drugs Actonel, Fosamax, Reclast, and Boniva. Bisphosphonates are used to prevent and/or treat osteoporosis. They have been shown to slow bone loss, increase bone density and reduce the risk of spine fractures. Actonel and Fosamax have also been shown to reduce risk of non-spine fractures.
- Evista. This drug is a selective estrogen receptor modulator (SERM) that has many estrogen-like properties. It is approved for prevention and treatment of osteoporosis and can prevent bone loss at the spine, hip, and other areas of the body. Studies have shown that it can decrease the rate of vertebral fractures by 30%-50%. It may increase the risk of blood clots like estrogen.
- Forteo is a type of hormone used to treat osteoporosis. It helps rebuild bone and increases bone mineral density. It is given by injection and is used as a treatment for osteoporosis.
- Prolia is a so-called monoclonal antibody -- a fully human, lab-produced antibody that inactivates the body's bone-breakdown mechanism. It is used to treat women at high risk of fracture when other osteoporosis drugs have not worked.