Medicines are used to both prevent and treat osteoporosis. Some medicines slow the rate of bone loss or increase bone thickness. Even small amounts of new bone growth can reduce your risk of broken bones.

If you take medicine for osteoporosis, you will also need to take calcium and vitamin D supplements, eat a healthy diet, and exercise regularly. A large part of treating or reducing the effects of osteoporosis is getting enough calcium and vitamin D.

Medication Choices

Medications for treatment and prevention

Medications used to prevent or treat osteoporosis include:

• Bisphosphonates, such as alendronate (Fosamax), ibandronate (Boniva), and zoledronic acid (Reclast), which slow the rate of bone thinning. These medicines may be used in men and women.

  Should I take bisphosphonate medications for osteoporosis?

• Raloxifene (Evista), a selective estrogen receptor modulator (SERM), which is used only in women. Raloxifene slows bone thinning and causes some increase in bone thickness.
• Calcitonin (Calcimar or Miacalcin), a naturally occurring hormone that helps regulate calcium levels in your body and is part of the bone-building process. When taken by shot or nasal spray, it slows the rate of bone thinning. Calcitonin also relieves pain caused by spinal compression fractures. Calcitonin is used in men and women.
• Parathyroid hormone (teriparatide [Forteo]), used for the treatment of men and postmenopausal women with severe osteoporosis who are at high risk for bone fracture. It is given by injection.

Hormone therapy

Hormone therapy for osteoporosis in women includes:

• Estrogen. Estrogen without progestin (estrogen replacement therapy, or ERT) may be used to treat osteoporosis in women who have gone through menopause and do not have a uterus. Because taking estrogen alone increases the risk of developing cancer of the lining of the uterus (endometrial cancer), ERT is only used if a woman has had her uterus removed (hysterectomy).
• Estrogen and progestin. Rarely, the combination of estrogen and progestin (hormone replacement therapy, or HRT) is recommended for women who have osteoporosis.

For men, testosterone (shots, gel, or patches) sometimes is given to prevent osteoporosis caused by low testosterone levels, although use of testosterone to treat osteoporosis has not been approved by the FDA.

A woman's level of the hormone estrogen, which affects the growth and loss of bone, decreases naturally during and after menopause. Estrogen replacement therapy (ERT) or combination estrogen/progesterone replacement therapy (HRT) can help to reduce bone loss. The Women's Health Initiative (WHI) study found that HRT decreased the risk of hip fracture, but it also led to small increases in a woman's risk of breast cancer, heart attack, stroke, blood clots (pulmonary embolism and deep vein thrombosis), and Alzheimer's disease and other dementias.^{14, 15} Estrogen alone (ERT), used for women who have had a hysterectomy, was found to increase a woman's risk of stroke, but it did not appear to affect rates of breast cancer or heart attack. 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.^{16, 17} To learn more about the study, see: WHI: Risks and benefits of taking HRT or ERT