If you have postmenopausal osteoporosis, treatment is key to preventing fractures and long-term complications. This condition develops after a loss of bone mass, which makes bones weak and prone to breaks.
Some medications are used to prevent bone loss, while others help rebuild bone and boost bone mass. Ultimately, these treatments can help reduce the risk of broken bones.
The early stages of osteoporosis often cause no symptoms, so you may not notice any changes in your condition after starting treatment. However, doctors can check your bone mineral density to determine whether your osteoporosis treatment is working.
Keep reading to learn about how to monitor osteoporosis treatment, including goals of different medications and when to consider switching to a different drug.
A bone density test can help determine whether your osteoporosis medication is working and helping achieve your treatment goals.
This is done using dual-energy X-ray absorptiometry (DEXA), a quick, painless process that involves lying on a table as an imaging arm moves over your body. You probably had this scan before you received an osteoporosis diagnosis.
Doctors typically recommend getting a bone density scan a few years after starting treatment, but this can vary from person to person and depending on the medication used.
A healthcare professional may also recommend blood and urine testing to help evaluate the effectiveness of your treatment.
Here are some signs that indicate that your osteoporosis treatment is working:
- Your bone density hasn’t decreased.
- You haven’t had further bone loss.
- You haven’t had any new fractures.
Osteoporosis treatment is typically recommended for postmenopausal women with:
- a bone mineral density T-score of -2.5 or less
- increased risk of fracture
- history of spine or hip fracture
There are two main categories of osteoporosis medications that can help lower the chances that you’ll break a bone: antiresorptives and anabolic agents.
Antiresorptive medications treat osteoporosis by slowing the process the body uses to break down old bone. They help prevent you from losing more bone mass.
Bisphosphonates are the most common antiresorptive medications used to treat osteoporosis. These include:
- alendronate (Fosamax)
- ibandronate (Boniva)
- risedronate (Actonel, Atelvia)
- zoledronic acid (Reclast, Zometa)
Bisphosphonates are generally well-tolerated as a first-line therapy. If these drugs don’t work, a doctor may recommend another type of antiresorptive medication, such as:
- denosumab (Prolia, Xgeva)
- calcitonin (Miacalcin)
- raloxifene (Evista), a selective estrogen receptor modulator (SERM)
- estrogen/bazedoxifene, a tissue-specific estrogen complex
Anabolic agents stimulate new bone formation, which can strengthen bones. These are typically recommended for people with severe osteoporosis who haven’t seen results from other medications.
Anabolic agents used to treat osteoporosis include:
- teriparatide (Bonsity, Forteo), a parathyroid hormone analog
- abaloparatide (Tymlos), a parathyroid hormone-related protein analog
- romosozumab (Evenity), a sclerostin inhibitor
Many osteoporosis medications are available in pill form, but others require injections or intravenous (IV) infusions.
Depending on the specific drug, your osteoporosis treatment may need to be administered:
- once a year
As with any medication, osteoporosis treatments come with the risk of side effects. A doctor can explain the potential benefits and side effects of each and recommend an osteoporosis treatment for you.
Osteoporosis treatment won’t cure or reverse the disease, but that doesn’t mean it’s not working. The goal of treatment is to reduce the risk of fractures and support bone health.
Each type of medication has its own treatment goals, as well. Antiresorptive medications are used to prevent further bone loss. The goals of anabolic agents for osteoporosis include:
- rebuilding bone
- repairing microscopic damage in bone
- boosting bone mass
Following your treatment plan as prescribed by a doctor increases the likelihood that it will help your osteoporosis.
If your osteoporosis treatment isn’t working, your doctor may recommend trying a different medication based on a variety of factors, such as:
- your risk of fracture
- your overall health
- your personal preferences
- potential side effects and risks of the drug
You may also need to switch osteoporosis medications if the current drug you’re taking causes side effects.
Talk with your doctor about the risks and benefits of different medications, and whether or not you should consider trying a different treatment.
In addition to taking osteoporosis medication, making changes to your diet and lifestyle can also support your bones and reduce the risk of fractures.
Calcium and vitamin D play an important role in bone health, so it’s important to make sure you’re getting adequate amounts of these nutrients. The National Institutes of Health recommends:
- 1,200 milligrams of calcium per day for women ages 51 and up
- 600 IUs (international units) of vitamin D per day up to age 70
- 800 IUs of vitamin D per day after age 70
Your doctor may recommend different doses based on your diet and overall health.
Calcium can be found in a variety of foods, such as seeds, dairy, beans, and sardines. Vitamin D is also found in common foods, like salmon, egg yolks, and mushrooms, but it’s primarily produced inside our bodies when we’re exposed to sunlight.
If you’re not getting enough calcium or vitamin D through your diet and lifestyle, your doctor may recommend taking an over-the-counter supplement.
A variety of lifestyle changes can also help lower the impact of osteoporosis. Here are some other tips:
- Perform weight-bearing exercises on a regular basis.
- Cut down on alcohol and caffeine.
- Quit smoking, if you smoke.
- Reduce tripping hazards and poor lighting in your home.
- Install grab bars or handrails where you need them.
- Use assistive devices, such as a cane or walker, if they help you feel more stable.
- Wear shoes that provide good grip and support.
- Stay socially active and involved. Social interactions may lift your spirits.
Postmenopausal osteoporosis doesn’t only affect your bones — it can impact your mental health, too. If you feel anxious or depressed or simply need some extra emotional support, talk with a mental health professional. An osteoporosis support group can also be a great option for emotional support.
Postmenopausal osteoporosis can be treated with several medications, including antiresorptives (like bisphosphonates) and anabolic agents. Getting bone density scans can help determine whether your osteoporosis treatment is working.
If your current treatment isn’t working, a doctor may recommend switching to a different medication. Your overall health and personal preferences should be part of the equation when choosing medications. It’s also important to discuss the potential risk of side effects.
There’s no one-size-fits-all treatment plan for postmenopausal osteoporosis. Along with medication, nutritional and lifestyle interventions can also be helpful in improving bone health and reducing the chances of a fracture.
If you’re concerned about the effectiveness of your osteoporosis treatment, get in touch with a doctor.