Treatment of osteoporosis

The main causes are a drop in estrogen levels in women during menopause and decreased testosterone in men. Women, especially those over 50, get osteoporosis more often than men.

Researchers estimate that about 20% of American women over age 50 have osteoporosis and 30% have osteopenia (low bone density abnormal) that may eventually lead to osteoporosis if not treated. From these figures, researchers estimate that 50% of women over age 50 will suffer a hip fracture, wrist, or vertebra (bones of the spine).

White women, especially those with a family history of osteoporosis, have a higher than average risk of developing the disease. Also, are identified as risk factors: cigarette smoking, the eating disorders, low body weight, low calcium diet, high alcohol consumption, early menopause, absence of menstrual periods (amenorrhea) and the use of certain medications such as steroids and anticonvulsants.

The treatment of all types of osteoporosis include calcium supplements and vitamin D, an exercise program appropriate for the patient, change in lifestyle to reduce risk factors and medications.

Medicines.

* Bisphosphonates: alendronate, risedronate, ibandronate
* Hormone replacement therapy: estrogen, estrogen-gestagen
* Tibolone
* Raloxifene
* Calcitonin
* Vitamin D, Vitamin D3 activates

Choosing a drug requires the patient characteristics, disease and our goals in the management of this disease. We can say that based on evidence based medicine there are some recommendations.

Bisphosphonates: These are first-line medicine in the treatment of postmenopausal osteoporosis prevention and treatment of steroid-induced osteoporosis and osteoporosis in men.

Hormone replacement therapy: first-line osteoporosis prevention and management of vasomotor symptoms associated with menopause. Second choice in the treatment of postmenopausal osteoporosis.

Calcitonin: second choice in the treatment of postmenopausal osteoporosis.

Calcium and vitamin D indicated in the prevention of osteoporosis

Monitoring Osteoporosis Treatment.

We have 2 parameters to evaluate the effectiveness of an osteoporosis treatment. The Bone Mineral Densitometry and markers of bone resumption.

Bone Densitometry.

It is easy to do a test that measures the amount of calcium that has a particular bone size, establishing whether this is normal, osteopenia or osteoporosis. We can measure different regions such as spine, hip, forearm, and calcaneus’s (heel) or total body. Indicates low bone mass increased risk of fracture. This procedure is used for diagnosis, but is useful in assessing people who have significant bone loss or to see the effectiveness of treatment. For this reason it requires a repeat at certain intervals (every 12 or 24 months).

The ideal in monitoring the treatment of osteoporosis is to have a Densitometry and the basic biochemical marker. The densitometry should be repeated 1 or 2 years after the first to observe the bone gain you could achieve with a medicine. Given that changes in bone densitometry are discrete (3-5%) is required to watch this time. Biochemical markers can repeat 2-3 months after starting treatment to inquire of the effectiveness of the drug used. An ideal response to treatment is the reduction of biochemical markers and increased bone mass, but arguably the goal of osteoporosis management is to reduce fracture risk and improve quality of life of the sufferer.