Talk to Your Doctor About Treatment Options
Bone continuously changes throughout life - old bone is constantly replaced by new bone. This process is called "remodeling" in which cells called osteoblasts build up bone and cells known as osteoclasts break down bone. Osteoporosis is caused when there is an imbalance in this cycle: too much bone is lost, too little bone is made, or both. This causes bone to become less dense, resulting in bones that are weaker and easier to break.
The objective of osteoporosis treatment is to prevent disease progression and reduce the risk of fracture. There are primarily two types of treatments approved by the FDA - antiresorptive medications that slow bone loss and anabolic agents that build bone.
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| Antiresorptive medications
Antiresorptive medications slow bone loss. When a person first starts taking these medications, bone loss quickly slows, but then the body continues to make new bone at a normal pace, meaning that bone density may increase. These treatments include the following classes of medications:
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- Bisphosphonates. Bisphosphonates are the most widely prescribed treatment for osteoporosis. They inhibit the activity of osteoclasts, meaning they help slow down the breakdown of bone. Bisphosphonates can be given orally or intravenously and are available in weekly, monthly, quarterly or once-yearly dosing options.
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- Calcitonin. This is a hormone that helps regulate calcium and bone processes. It works by blocking the activity of osteoclasts.
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- Estrogen therapy / hormone therapy. These are therapies only for women that consist of estrogen alone or estrogen combined with progestin. Estrogen has been shown to have a protective effect on bone; however, doctors usually prescribe estrogen with progestin because taking estrogen by itself increases a woman's risk for uterine cancer.
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