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How Can Osteoporosis be Treated?

Estrogen replacement therapy (ERT) is approved by the Food and Drug Administration (FDA) for both the prevention and treatment of osteoporosis. Some post-menopausal women take the female hormone estrogen. The body produces less estrogen after menopause. One of the purposes of estrogen replacement therapy is to lower the number of fractures by decreasing the loss of bone mass.

Estrogen therapy is most effective if begun within three years of menopause. Twenty-five percent of post-menopausal white women have fractures; the percentage of post-menopausal African American women who have fractures is less. Therefore, not everyone needs estrogen therapy. Since there are possible complications, estrogen therapy is recommended only for women especially at risk.

The complications of estrogen therapy include an increased risk of uterine cancer, which may be offset by taking progestin. However, caution is necessary because progestin itself has side effects, including raising the cholesterol level. Research results have been mixed with respect to whether women using estrogen therapy have a higher risk of breast cancer.

In 1993, the National Institute of Health began a nine-year study of hormone use to more definitively determine the risks.

The best advice is to discuss fully with your health care provider whether estrogen therapy is right for you. Make sure your health care provider knows about any complications you have concerning blood clotting, liver disease or seizures.

Other treatment options include calcitonin and alendronate. Calcitonin has been shown to slow bone breakdown and also reduce the pain associated with osteoporotic fractures. Alendronate works by inhibiting the cells that remove or reabsorb bone. The cells that form new bone are unaffected, thus, the net effect is to gain bone. Both of these drugs have been approved by the FDA for treatment of post-menopausal osteoporosis. Only ERT has been approved by the FDA for prevention and treatment of osteoporosis.

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