Drugs for Osteoporosis

Drugs for osteoporosis have different side effects. There certainly isn't a "one size fits all". Alendronate may cause you more difficulty with stomach irritation, and Risedronate may not. Ibandronate may be your choice because it only needs to be taken once a month. 

Bone Density and Menopause

Has your doctor told you your bone density will likely reduce even further after menopause? Has your doctor prescribed HRT treatment, but it's against your instincts to take it? Many women have felt this way because of the conflicting information they've discovered about the safety of HRT treatment. 

Drugs for Osteoporosis

Hormone Replacement Therapy

A half a century ago, the Western world thought they discovered the Holy Grail of supplemental estrogen. Hormone treatment became a popular way to halt the aging process, alleviate menopausal symptoms, and prevent postmenopausal health risks. 

Estrogen and progesterone are hormones produced naturally by the ovaries. These hormones decrease the onset of menopause, which results in a different balance of hormones after menopause. 

It's true that after menopause the ovaries go on producing lesser amounts of estrogen, and androgens produced by the adrenal glands are converted into a weak form of estrogen, but this doesn't mean that estrogen deficiency isn't normal. 

With the availability of prescription hormones for women, the concept of "estrogen-deficient" was created to help bring women hormone levels back to "normal". 

HRT was seen as the answer to preventing a variety of serious conditions while simultaneously keeping women young. Doctors became to embrace estrogen replacementwhile massive marketing campaigns successfully appealed to women's vanity and desire for "eternal youth". 

For many women, HRT became the accepted way to manage ups and downs during menopause. HRT was thought to be the answer to relieving menopause symptoms such as hot flashes, night sweats, sleep disturbances, mood swings and vaginal dryness while simultaneously preventing heart disease and osteoporosis. 

HRT for Osteoporosis

Early on, HRT was found to slow bone density loss through the menopause transition and normal age-related bone loss was identified as a major cause of osteoporosis in older women. As a result, women were advised to undergo a long-term treatment for HRT to replace the missing bone protective hormones. 

This promise of a single pill that would treat long term diseases was very compelling and many healthy women proceeded with HRT treatment for diseases they may never develop. 

By 2001, HRT was the #1 prescription drug in the world. By 2002, 38 percent of postmenopausal women in the United States were using HRT, making it the most frequently prescribed medication in the United States. 

Long-term effects of HRT

Research showed HRT relieved hot flashes and treated vaginal dryness in postmenopausal women. However, no clinical trials had proven that HRT prevented heart disease and fractures. Most importantly, long-term effects of the treatment were unknown. 

Fractures, HRT, and Drugs for Osteoporosis

What about fractures? 

It is true that HRT slows bone density loss in women who use it, but reducing bone loss and preventing fractures are two very different goals in managing osteoporosis. 

There were no long-term studies showing the effects of HRT. In 2001, the FDA had withdrawn its approval of HRT as a treatment for osteoporosis. In 2002, WHI (Women's Health Initiative trial showed results that indicated that HRT significantly increased the risk of serious disease. Also, the U.S. Preventative Services Task Force would later advise against using HRT for osteoporosis prevention because of the concerns surrounding long-term safety. 

Are current treatments safe?

Have you heard the expression, "The cure is worse than the disease"? 

Researchers try to uncover a drug's side effects prior to submitting it for approval to the FDA. However, unanticipated side effects can surface long after a drug has been approved. Drugs for osteoporosis treatment are relatively new, and few long-term studies have been conducted. 

The most common treatment for osteoporosis right now is bisphophonates alendronate and risedronate. These are the most potent of the antiresorptive drugs, because they slow down the normal bone remodeling process. Bone remodeling is essential for maintaining healthy bone. 

All the bisphosphonates vary in their side effects and their dosing regimens. People also respond to drugs for osteoporosis differently, so if you start experiencing side effects, don't hesitate to tell your doctor. 

There is now evidence bisphosphonates prevent the routine removal of micro-damage (bone remodeling), which may be causing an accumulation of microfractures. Also, there are concerns that long-term use may reduce bone strength and actually increase fractures. 

Do drugs for osteoporosis that suppress bone remodeling reduce or increase the risk of fracture in the long term? 

› Drugs for Osteoporosis

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