Treating osteoporosis involves treating and preventing fractures, and using medication to strengthen bones.

Treating osteoporosis involves treating and preventing fractures, and using medication to strengthen bones.

An important objective for health services across England is to try to prevent falls and fractures, particularly in people with osteoporosis and those with risk factors for osteoporosis.

The key messages for older people and their family and carers are:

  • falls are a risk as you get older but aren't inevitable – there are measures you can take to prevent falls or reduce the harm that might be caused by falling
  • staying active and healthy – for example, through exercise and diet – is likely to keep you independent and reduce your risk of falling
  • if you're unsteady on your feet or you fall, speak to your GP so that possible causes of falls, such as poor eyesight, certain medications, and poor muscle strength and balance, can be identified and treated

Read more about the types of exercise you can do to prevent osteoporosis and lower your risk of falls.

Treatment overview

Although a diagnosis of osteoporosis is based on the results of your bone mineral density scan (DEXA or DXA scan), the decision about what treatment you need, if any, is also based on a number of other factors. These include your:

  • age
  • sex
  • risk of fracture
  • previous injury history

If you've been diagnosed with osteoporosis because you've had a fracture, you should still receive treatment to try to reduce your risk of further fractures.

You may not need or want to take medication to treat osteoporosis. However, you should ensure you're maintaining sufficient levels of calcium and vitamin D. To achieve this, your healthcare team will ask you about your diet and may recommend making changes or taking supplements.

Medication for osteoporosis

A number of different medications are used to treat osteoporosis. Your doctor will discuss the treatments available and make sure the medicines are right for you.

A number of factors are taken into consideration before deciding which medication to use. These include your:

  • age
  • bone mineral density (measured by your T score)
  • risk factors for fracture


Bisphosphonates slow the rate that bone is broken down in your body. This maintains bone density and reduces the risk of fracture.

There are a number of different bisphosphonates, including:

  • alendronate
  • ibandronate
  • risedronate
  • zoledronic acid

They're given as a tablet or injection.

You should always take bisphosphonates on an empty stomach with a full glass of water. Stand or sit upright for 30 minutes after taking them. You'll also need to wait between 30 minutes and 2 hours before eating food or drinking any other fluids.

Bisphosphonates usually take 6 to 12 months to work, and you may need to take them for 5 years or longer. You may also be prescribed calcium and vitamin D supplements to take at a different time to the bisphosphonate.

The main side effects associated with bisphosphonates include:

Not everyone will experience these side effects.

Osteonecrosis of the jaw is a rare side effect linked with the use of bisphosphonates, although most frequently with high-dose intravenous bisphosphonate treatment for cancer and not for osteoporosis.

In osteonecrosis, the cells in the jaw bone die, which can lead to problems with healing. If you have a history of dental problems, you may need a check-up before you start treatment with bisphosphonates. Speak to your doctor if you have any concerns.

Read more about bisphosphonates for treating osteoporosis.

Selective oestrogen receptor modulators (SERMs)

SERMs are medications that have a similar effect on bone as the hormone oestrogen. They help to maintain bone density and reduce the risk of fracture, particularly of the spine.

Raloxifene is the only type of SERM available for treating osteoporosis. It's taken as a daily tablet.

Side effects associated with raloxifene include:

Read more about raloxifene for treating osteoporosis.

Parathyroid hormone (teriparatide)

Parathyroid hormone is produced naturally in the body. It regulates the amount of calcium in bone.

Parathyroid hormone treatments (human recombinant parathyroid hormone or teriparatide) are used to stimulate cells that create new bone (osteoblasts). They're given by injection.

While other medication can only slow down the rate of bone thinning, parathyroid hormone can increase bone density. However, it's only used in a small number of people whose bone density is very low and when other treatments aren't working.

Nausea and vomiting are common side effects of the treatment. Parathyroid hormone treatments should only be prescribed by a specialist.

Read more about teriparatide for treating osteoporosis.

Calcium and vitamin D supplements

Calcium is the major mineral found in bone, and having enough calcium as part of a healthy, balanced diet is important for maintaining healthy bones.

For most healthy adults, the recommended amount of calcium is 700 milligrams (mg) of calcium a day, which most people should be able to get from a varied diet that contains good sources of calcium.

However, if you have osteoporosis, you may need more calcium, which will usually be in the form of supplements. Ask your GP for advice about taking calcium supplements.

Vitamin D is needed to help the body absorb calcium. All adults should consume 10 micrograms of vitamin D a day from October to March.

Because vitamin D is found in only a small number of foods, it might be difficult to get enough from your diet alone – so all adults should consider taking a daily supplement containing 10 micrograms of vitamin D.

For more information, read about who should take vitamin D supplements.

Hormone replacement therapy (HRT)

HRT is sometimes recommended for women who are experiencing the menopause, as it can help control symptoms.

HRT has also been shown to maintain bone density and reduce the risk of fracture during treatment.

However, HRT isn't specifically recommended for treating osteoporosis and isn't often used for this purpose.

This is because HRT slightly increases the risk of developing certain conditions – such as breast cancer, endometrial cancerovarian cancer, stroke and venous thromboembolism – more than it lowers the risk of osteoporosis.

Discuss the benefits and risks of HRT with your GP.

Read more about the risks of HRT.

Testosterone treatment

In men, testosterone treatment can be useful when osteoporosis is caused by insufficient production of male sex hormones (hypogonadism).

Page last reviewed: 19/06/2016
Next review due: 19/06/2019