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Top treatments for osteoporosis

Prevention is the best treatment for osteoporosis, but if you have already experienced thinning bones or osteoporosis-related fractures, you need to know your best medical options. Here are some of the treatments that could help you overcome this life-threatening disease.

Estrogen - Estrogen therapy is the most commonly prescribed treatment for osteoporosis. Estrogen is directly involved in bone metabolism and may also help you absorb calcium. Women who begin estrogen replacement therapy within three years of menopause and remain on it for six to nine years lower their risk of fractures of the spine, wrist, and hip by 50 to 70 percent.

Estrogen therapy has its pros and cons. Besides protecting your bones, estrogen can relieve the hot flashes and vaginal dryness that sometimes accompany menopause, reduce mood swings, improve sleep, and lower the risk of Alzheimer's, colon cancer, and heart disease. But it also may cause vaginal bleeding, weight gain, breast tenderness, nausea, and headaches. And some studies have suggested that it could increase your risk of breast or endometrial cancer.

Raloxifene (Evista) - This medicine is a Selective Estrogen Receptor Modulator (SERM). It acts like an estrogen on bone cells but not on breast and uterine tissue. Therefore, it isn't as likely to cause some of the side effects of estrogen replacement therapy, like vaginal bleeding or increased risk of breast or endometrial cancer. It may even protect against breast cancer.

However, it won't help you with other symptoms of menopause like hot flashes, and it may not be as effective on bone mass as estrogen. It may be a good choice for women who want to protect their bones but are concerned about the long-term effects of estrogen therapy.

Alendronate (Fosamax) - This drug is a bisphosphonate, which is a form of a compound that naturally occurs in bone. Studies have found that it increases bone mass and reduces fracture risk, even in older women with previous fractures. One drawback is that you have to take it with water while sitting upright, because it can damage your esophagus if it doesn't pass quickly into your stomach.

Risedronate (Actonel) - In two large studies, this new drug reduced the risk of new spinal fractures by up to 74 percent in post-menopausal women after just one year of treatment. It is the first drug found to affect spinal fracture risk that quickly, so it could be extremely valuable in treating women who have already had spinal fractures.

Calcitonin - This drug is available as an injection and as a nasal spray. It reduces bone loss, but there is less evidence that it helps prevent fractures, so it may not be a good choice for people who have already suffered fractures.

Osteoprotegerin - This natural protein isn't available as a treatment yet, but one large study found that just one shot cut bone loss by 80 percent in postmenopausal women. After a month, however, the women had returned to their pre-shot rate of bone loss, so you would have to get monthly shots for it to be effective.

Many more studies are needed before this drug would be approved, but it may lead to a new and effective way to treat osteoporosis in the future.



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