Based upon the unique situation of each patient, a medical professional may prescribe medications that will slow the body’s reabsorption rate of bone to help prevent worsening osteoporosis.
Apart from this, many other medications are available that will help prevent and/or treat osteoporosis. The correct medication for each patient can be different depending on medical history and risk factors. A licensed medical professional will determine which medication will provide the best results for a specific patient.
For postmenopausal women, hormone replacement therapy can be beneficial to reverse osteoporosis. A variety of studies have shown that over 80% of women who undergo hormone replace therapy see up to a 2% increase in bone mass each year. The presence of estrogen has demonstrated an overall decrease in fractures of the spine by 50% and fractures of the hip by 25%. Apart from these benefits, hormone replacement therapy can also help to lower the risk of coronary artery disease, ease menopause, and potentially delay or prevent Alzheimer’s.
Many women, however, worry about the long-term risks of hormone replacement therapy. Various studies have linked an increased risk of breast cancer to this therapy. For patients who have any family history of breast cancer or those that have suffered from medical conditions such as a stroke or a blood clot, this type of therapy is not often recommended. Women that do not find themselves in the aforementioned group should seriously consider hormone replacement therapy as medical professionals estimate that, if this therapy were widely used, fractures caused by osteoporosis could decrease by as much as 50% to 75%.
This type of therapy requires continued practice. If a woman stops taking estrogen as part of her hormone replacement therapy, bone loss will occur at a quick rate again. Within a period of seven years, a woman who stopped taking estrogen will have the same bone density as that of a woman who never started.
Alternative therapies include the usage of calcitonin. Calcitonin is a non-steroidal hormone that binds to osteoclasts, decreases their numbers, and lowers their activity levels. This process helps to lower the reabsorption of bone and, in turn, slow osteoporosis. Methods of treatment include an injection, nasal spray, and a rectal suppository. The nasal method is most often provided to women who are at least five years post-menopause and cannot be treated by other methods. In addition to slowing bone reabsorption, calcitonin also has a penchant to help ease pain.
For those patients that take calcitonin, the medication will need to be monitored closely by a medical professional. As this is a newer medication, the long-term effects are not well known. What is known is that approximately 20% of calcitonin users eventually develop a resistance to the medication meaning that an alternative treatment will be needed to treat osteoporosis.
Another group of medications useful in the fight against osteoporosis are bisphosphonates. These drugs also slow the bone reabsorption rate by affecting osteoclasts, much like calcitonin. Common medications in this group include Ibandronate, Alendronate, and Risedronate.
These medications, depending on which one is chosen, can be taken as a daily pill, a weekly or monthly dose, or an annual injection. Zoledronate can be provided as a yearly annual injection while Ibandronate can be taken via pill or by injection every three months. The injectable versions of these medications are most commonly used with postmenopausal women.
A variety of research has shown that this group of medication increases overall bone mass but does not result in a reversal of bone mass growth if the medication is stopped like in hormone replacement therapy. Regardless, close monitoring by a professional will need to be done as the long-term effects of bisphosphonates are not well known as well as the fact that side effects can appear suddenly.
Medication research for osteoporosis is ever evolving and is constantly being researched. Medications such as sodium fluoride have shown positive results in individuals with low-turnover osteoporosis by increasing the bone mass production of osteoblasts. While this medication is not yet available, another potential treatment drug is known as Raloxifene.
Raloxifene is an anti-estrogen medication also referred to as selective estrogen-receptor modifiers (SERMs). SERMs been shown to have similar results to normal estrogen but does not increase the long-term risk for breast cancer. As such, it is mainly prescribed to postmenopausal woman less than 65 years old. These women cannot have a history of, or be at risk for, blood clots or a form of cardiovascular disease.
For men, the anabolic medication known as Teriparatide can be prescribed for the management of osteoporosis. This medication is a kind of parathyroid hormone that is used for high-risk patients as it helps to build muscle and bone mass. Another medication with antiresorptive properties, like a bisphosphonate, often accompanies it.
Overall, changes in lifestyle, a sold exercise regimen, hormone replacement therapy, and continued advances in modern medicine can help patients control their osteoporosis. Between a patient, their doctors, and our team of physical therapists, the best course of treatment to help prevent fractures will be found.
Hicksville Physical Therapy provides a variety of physical therapy services in Hicksville, New York, and the surrounding area.