Medical interventions may lower the risk of fractures.
Osteoporosis medication is primarily designed to reduce resorption or increase bone formation. Your course of treatment will depend on whether you have osteoporosis, have an osteoporotic fracture or are at high risk for fractures. Do remember to talk with your doctor before starting any new treatment, and to go over the benefits and possible side effects of the medication.
- Bisphosphonates may slow the rate that bone is broken down in your body. It helps to increase bone density and reduce the risk of spine, hip and non-vertebral fractures.
- Bisphosphonates can be taken by mouth (orally), through a drip (intravenous infusion) or by injection. Frequency of treatment depends on the route of administration.
- Bisphosphonates are generally well tolerated. Less common side effects include fever, muscle and joint pains, flu-like symptoms and headaches. Do speak with your doctor about the possible side effects of your treatment.
- Denosumab may help to increase bone mass and strength in women who are at high-risk of osteoporotic fractures.
- Denosumab is usually prescribed for osteoporosis in postmenopausal women who are unable to take bisphosphonates.
- Denosumab is a subcutaneous injection and usually given every 6 months.
3. Hormone Replacement Therapy (HRT)1-2
- Oestrogen is a female sex hormone, instrumental in maintaining good bone health. Postmenopausal hormone therapy focuses on using oestrogen by increasing your levels of oestrogen and preventing osteoporosis. It is also beneficial in helping to control menopausal symptoms.
- HRT may increase the risk of developing certain conditions such as breast cancer, endometrial cancer, ovarian cancer, strokes and venous thromboembolism.
- You are strongly recommended to speak with your doctor about the risks of HRT.
4. SERMS (selective oestrogen receptor modulators)1-2
- SERMS have a similar effect on bone as oestrogen, and may help strengthen bones and prevent fractures.
- SERMS are typically used to reduce the risk of fracture of the spine in women with postmenopausal osteoporosis but not nonvertebral or hip fractures.
- Some less common side effects may include hot flashes, night sweats, muscle and joint aches, and leg cramps.
5. Parathyroid hormone therapy4-5
- Parathyroid hormone therapy uses a synthetic form of the hormone produced by the parathyroid glands, which helps to regulate the amount of calcium in our bones, stimulate new bone growth and increase bone mass.
- Some less common side effects may include nausea, headache, dizziness and pain in the limbs.
- Parathyroid hormone therapy is generally not recommended for patients with hyperparathyroidism, and other bone diseases (such as Paget's disease), bone cancer and a history of radiation therapy involving the bones.
- Cosman, F., de Beur, S.J., LeBoff, M.S. et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int 25, 2359–2381 (2014). https://doi.org/10.1007/s00198-014-2794-2.
- Slovik D. Endocrinology Metabolism. Postmenopausal osteoporosis Available at: https://www.endocrinologyadvisor.com/home/decision-support-in-medicine/endocrinology-metabolism/postmenopausal-osteoporosis/. Accessed: April: 2020.
- Mayo Clinic News Network. Finding the right osteoporosis medication (2017, October 17). Available at: https://medicalxpress.com/news/2017-10-osteoporosis-medication#:~:text=Denosumab%20may%20be%20considered%20a,more%20advanced%20chronic%20kidney%20disease. Accessed: April 2020.
- Wein MN. Parathyroid Hormone Signaling in Osteocytes. JBMR Plus. 2017;2(1):22-30. Published 2017 Nov 10. doi:10.1002/jbm4.10021.
- Kanis JA, McCloskey EV, Johansson H, et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013;24(1):23-57. doi:10.1007/s00198-012-2074-y.