Osteoporosis: Diagnosis and Management

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For both men and women at increased risk of fracture, the most widely prescribed osteoporosis medications are bisphosphonates.

Osteoporosis - Diagnosis and treatment - Mayo Clinic

Side effects include nausea, abdominal pain and heartburn-like symptoms. These are less likely to occur if the medicine is taken properly. Intravenous forms of bisphosphonates don't cause stomach upset but can cause fever, headache and muscle aches for up to three days.

And it may be easier to schedule a quarterly or yearly injection than to remember to take a weekly or monthly pill, but it can be more costly to do so. Using bisphosphonate therapy for more than five years has been linked to a very rare problem in which the middle of the thighbone cracks and might even break completely. Bisphosphonates also have the potential to affect the jawbone. Osteonecrosis of the jaw is a rare condition that can occur typically after a tooth extraction in which a section of jawbone fails to heal where the tooth was pulled.

You should have a recent dental examination before starting bisphosphonates. Estrogen, especially when started soon after menopause, can help maintain bone density. However, estrogen therapy can increase the risk of blood clots, endometrial cancer, breast cancer and possibly heart disease. Therefore, estrogen is typically used for bone health in younger women or in women whose menopausal symptoms also require treatment.

New Drugs Improve Osteoporosis Treatment

Raloxifene Evista mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen. Taking this drug may reduce the risk of some types of breast cancer. Hot flashes are a common side effect. Raloxifene also may increase your risk of blood clots.

Diagnosis and Management of Osteoporosis

In men, osteoporosis may be linked with a gradual age-related decline in testosterone levels. Testosterone replacement therapy can help improve symptoms of low testosterone, but osteoporosis medications have been better studied in men to treat osteoporosis and thus are recommended alone or in addition to testosterone. If you can't tolerate the more common treatments for osteoporosis — or if they don't work well enough — your doctor might suggest trying:. These suggestions may help reduce your risk of developing osteoporosis or experiencing broken bones:.

Soy protein appears to have activity similar to estrogen on bone tissue. Some studies indicate that bone fracture risk is lessened in postmenopausal Asian women who consume higher amounts of soy protein. But soy should be used with caution by women who have a family or personal history of breast cancer. Most available soy products have not been shown to reduce the chance of fractures.


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Ipriflavone is a product made in a laboratory from one of the isoflavones found in soy. When combined with calcium, ipriflavone appears to prevent bone loss and reduce pain associated with compression fractures in the spine. Your family doctor may suggest bone density testing. Screening for osteoporosis is recommended for all women by age Some guidelines also recommend screening men by age 70, especially if they have health issues likely to cause osteoporosis.

If the bone density test is very abnormal or you have other complex health issues, you might be referred to a doctor who specializes in metabolic disorders endocrinologist or a doctor who specializes in diseases of the joints, muscles or bones rheumatologist. Here's some information to help you get ready for your appointment, and what to expect from your doctor. Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out.

INTRODUCTION

For osteoporosis, some basic questions to ask your doctor include:. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something. Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on.

Your doctor may ask:.

Diagnosis and management of osteoporosis.

Mayo Clinic does not endorse companies or products. Calcium and bone health: Best Practice Journal Oct; Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women amended.

Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women amended. The care of patients with fragility fracture. J Clin Endocrinol Metab.

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Improving Outcomes in Hip Fracture Management. Published in September Position statement — orthogeriatric care.

Evidence-based guidelines for the management of hip fractures in older persons: