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Treating osteoporosis

Te whakarauora i te kōiwi ngoikore

elderly couple taking medication pillsHow your osteoporosis is treated depends on the results of your bone density scans, your age, gender, medical history and how bad your osteoporosis is. The treatment for osteoporosis most commonly involves lifestyle changes and medications.

Treating osteoporosis aims to increase your bone density and reduce your risk of breaking bones. If your bone density is slightly low, you may need to take vitamin D supplements.

To help decide which treatment is suitable, you or your doctor can use the Fracture risk assessment calculation tool (FRAX) or Know Your Bones. This shows your risk of having a fracture because of osteoporosis in the next ten years. The FRAX score uses your risk factors for osteoporosis and the result of a bone density scan (DXA) if you've had one.

Supplements for osteoporosis

Some people have difficulty getting enough calcium from food sources, so your doctor may recommend calcium supplements. There is some disagreement over using calcium supplements, as some studies have shown they increase the risk of heart problems, particularly in older people.

Your body makes most of the vitamin D it needs in your skin when exposed to sunlight. Vitamin D is essential for having healthy bones and muscles.

Some people, such as those who spend a lot of time indoors and those with dark skin, have difficulty producing enough vitamin D. If you're at risk of having low levels of vitamin D or if you have osteoporosis, your doctor may recommend you take vitamin D tablets such as colecalciferol.

See How to get your daily vitamin D for more information.

Medications for osteoporosis

Medicines for osteoporosis work by slowing or stopping bone loss. The main types of medication used to treat osteoporosis are:


These medicines work on your bone‑making cells to slow bone loss. They reduce the fracture rate in people with osteoporosis.

Examples of bisphosphonate medication used to treat osteoporosis include alendronic acid (Fosamax) and risedronate tablets.

You usually take bisphosphonates tablets with vitamin D supplements. A common side effect of these medications may be heartburn and indigestion.

An alternative to tablets is zoledronic acid, which you take as an infusion. You need an infusion very 12 to 18 months.

Menopause hormone therapy (MHT)

MHT (previously called hormone replacement therapy, HRT) used to be a treatment for osteoporosis in women with low estrogen levels (usually due to menopause). This treatment increases bone density and reduces fracture rates. But it can have side effects, so the risks and benefits need to be weighed up for each woman. Older postmenopausal women are particularly vulnerable to these risks.

MHT is used less often today but still has a role in some circumstances. Men with low testosterone levels may also benefit from testosterone replacement.

Selective estrogen receptor modulators (SERMs)

An example of a SERM is raloxifene. It reduces the number of fractures in the spinal column. It works by copying the effects of estrogen on bone, so increases bone density. Postmenopausal women who cannot take estrogen might need a SERM.

Other medications

Other medications to treat osteoporosis include denosumab and teriparatide. They're generally only used if other treatment options have not been successful.

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Content shared between HealthInfo Canterbury, KidsHealth and Health Navigator NZ as part of a National Health Content Hub collaborative. Last reviewed September 2023.


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