Osteoporosis (or porous bone) is a disease in which bones become weak and, therefore, are more likely to break. Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks (fractures).
Hormone replacement therapy (HRT)
Oestrogen seems to protect bone strength. The drop in oestrogen that occurs following menopause is mirrored by an increased loss of bone for a few years thereafter. The loss continues, but less steeply, in older women. Hormone replacement therapy replaces oestrogen and so reduces the rate of bone loss. HRT is thought to be of most benefit for preventing osteoporosis if it is started early in menopause and is taken for at least five years. Briefly, HRT is known to be associated with an increased risk of breast cancer, cancer of the lining of the womb (endometrial cancer), blood clots in the veins (thrombosis), stroke and heart disease.
HRT remains an option for women over 50 at risk of fractures for whom these other medicines are not suitable. HRT is also still a suitable option for women who have had an early menopause.
Bisphosphonates
Bisphosphonates are medications that slow the breakdown and removal of bone (ie, resorption). They are widely used for the prevention and treatment of osteoporosis in postmenopausal women. The most common side effects associated with bisphosphonates are digestive in nature, for example indigestion, diarrhoea, constipation and abdominal pain.
Kyphoplasty
It is also known as balloon kyphoplasty is a newer procedure. It involves placing a catheter with a balloon into a compressed vertebral body and slowly inflating the balloon to reduce the fracture. A special surgical cement is then injected into the space created by the balloon. The procedure stabilizes the fracture and restores vertebral body height.
Vertebroplasty
It is similar to Kyphoplasty, except a balloon is not used in this procedure.
Strontium ranelate
Strontium ranelate (Protelos) is used for the treatment of osteoporosis in postmenopausal women. It is usually reserved for women who cannot take bisphosphonates.
Raloxifene
Raloxifene (Evista) is a type of medicine called a selective oestrogen receptor modulator (SERM). It can be used to both prevent and treat osteoporosis in postmenopausal women.