Being told you have osteoporosis can feel overwhelming. You may wonder what happens next or how serious the condition is. The truth is, osteoporosis is very treatable — especially if you take action early. There are now more treatments for osteoporosis than ever before.

In this article, you’ll find seven treatment options that doctors often recommend, plus answers to important questions like what happens if osteoporosis is left untreated and what to do after you’re diagnosed.

1. Bisphosphonates

Bisphosphonates are often the first medication doctors prescribe for osteoporosis. These drugs help slow the process that breaks down bone. That gives your body time to rebuild and strengthen your bones. Bisphosphonate drugs include:

• Alendronate (Binosto, Fosamax)
• Ibandronate (Boniva)
• Risedronate (Actonel, Atelvia)
• Zoledronic acid (Reclast)

Some bisphosphonates are taken orally, while others are injected intravenously. Dosing schedules vary widely, with different formulations taken each week, once a month, or even once a year.

Common side effects of bisphosphonates include bone or muscle pain and, for those taken orally, gastrointestinal problems. Rare but serious side effects of bisphosphonates can include osteonecrosis (bone death) of the jaw, especially after dental surgery.

2. Denosumab

Denosumab is a type of medication called a biologic. It’s sold under the brand name Prolia. A biologic is a genetically engineered antibody, or protein, used by the immune system to identify and neutralize substances. Denosumab works by blocking a protein in the body that causes bone to break down.

Denosumab is administered once every six months by injection. Denosumab is approved by the U.S. Food and Drug Administration (FDA) to treat postmenopausal women and men who are at high risk for fractures, especially if other treatments haven’t worked well. It’s also commonly used for people with kidney issues.

Common side effects of denosumab include bone or muscle pain, gastrointestinal issues like nausea or diarrhea, fatigue, or headache. Rarely, it can cause very low calcium levels or issues with the jaw. It’s important to stay on schedule with this medication, because stopping it suddenly can lead to a higher risk of spinal fractures.

3. Romosozumab

Romosozumab (Evenity) is one of the newest osteoporosis treatments available. It’s a monthly injection given for 12 months, and it’s unique because it does two things at once: it helps build new bone and slows down bone loss.

Romosozumab is FDA approved for men and postmenopausal women who have a very high risk of fractures, such as those who’ve already broken bones, as well as for people whose osteoporosis hasn’t improved on other medications. Because of possible heart-related side effects, it isn’t recommended for people who’ve recently had a heart attack or stroke.

In clinical trials, less than 5 percent of people taking romosozumab reported joint pain or headaches. Your doctor can help you weigh the risks and benefits.

4. Hormonal Treatments

Both synthetic and natural hormone-based therapies can treat osteoporosis.

Abaloparatide and Teriparatide

Both abaloparatide (Tymlos) and teriparatide (Forteo) are daily injections that stimulate your body to grow new bone. They work by copying natural hormones that encourage bone-building cells to work harder. They’re typically given for up to two years, followed by another medication to keep the new bone strong.

Some people may feel dizzy or nauseated or get headaches while on these drugs. They aren’t recommended for people with a history of bone cancer, but they can be very effective for those at high risk of serious breaks.

Calcitonin

Calcitonin is an older treatment that comes as a nasal spray or injection. It helps slow down bone loss, and it may also ease pain after a spinal fracture. However, it’s not as effective as newer treatments, so it’s less commonly used today. Side effects may include nasal irritation when using the nose spray or nausea.

Hormone Replacement Therapy

Hormone replacement therapy (HRT) may provide an effective way for people going through menopause to prevent or treat osteoporosis. The most common ways to receive HRT are via oral medication, topical creams, vaginal ring, or a transdermal patch applied to the skin. Side effects include an increased risk of blood clots and heart disease. Not all methods of HRT are equally helpful for preventing osteoporosis, so talk with your doctor about which is best for your needs.

Duavee and Raloxifene

Raloxifene, sold under the brand name Evista, is a selective estrogen receptor modulator (SERM). It acts like estrogen in your bones, helping to keep them strong without affecting other parts of the body as much. It’s taken as a daily pill and helps prevent spine fractures.

Duavee is a combination drug composed of a mixture of estrogens and bazedoxifene (another SERM), which also works to protect bone density. Duavee is taken orally once a day.

These medications may cause hot flashes, leg cramps, or increase the risk of blood clots.

5. Surgeries for Fractures

Sometimes, osteoporosis leads to broken bones that need surgery, especially in the spine and hip. For painful spinal fractures, there are two types of procedures: vertebroplasty and kyphoplasty. These involve injecting a special cement into the broken bone to help it heal and stop the pain.

Hip fractures often require major surgery, and recovery can take months. Some people never regain full mobility. The risk of death increases in the year after hip surgery.

6. Healthy Eating for Stronger Bones

Eating the right food can help build stronger bones. People with osteoporosis need more of certain nutrients than other people. Make sure to eat plenty of foods with calcium and vitamin D to fight osteoporosis. Calcium is key — you can get it from dairy products, kale, sardines, fortified soy milk, and orange juice. Foods rich in vitamin D include tuna, mackerel, salmon, egg yolks, and fortified products such as some milk, soy milk, orange juice, and cereal.

Try to limit salt and alcohol, which can weaken bones if you consume too much. Protein is important, but don’t go overboard. Some studies show that very high-protein diets may reduce calcium in your bones.

7. Exercise and Fall Prevention

Staying active is one of the best things you can do for your bones. Weight-bearing activities like walking, dancing, or lifting weights can build bones. Many weight-bearing exercises can even be done in a seated position.

Even stretching or gentle movement helps improve balance and flexibility, which lowers your chance of falling. Exercises that focus on balance and flexibility include tai chi and yoga.

At home, simple changes like removing loose rugs, using night lights, and adding grab bars in the bathroom can help prevent dangerous falls. If you feel unsteady, using a cane or walker outdoors can help keep you stable.

What Happens If Osteoporosis Is Left Untreated?

If you don’t treat your osteoporosis, your bones will keep getting weaker over time. That means your chances of breaking a bone — like a hip, spine, or wrist — go up. After the first fracture, the risk of another increases. These fractures can be painful and take a long time to heal. For older adults, they can be life-changing.

Some people lose height or develop a hunched back from spinal fractures. Hip fractures are especially dangerous and can even increase the risk of death in the year after the injury. That’s why it’s so important to treat osteoporosis early and stick with your care plan.

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On MyOsteoTeam, people share their experiences with osteoporosis, get advice, and find support from others who understand.

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