If you have postmenopausal osteoporosis, treatment is key to preventing fractures and long-term complications. This condition develops after a loss of bone mass, which makes your bones weak and prone to breaks.

Some medications prevent bone loss, while others help rebuild bone and boost bone mass. Ultimately, these treatments can help reduce the risk of broken bones.

The early stages of osteoporosis often cause no symptoms, so you may not notice any changes in your condition after starting treatment. But doctors can check your bone mineral density to find out whether your osteoporosis treatment is working.

Keep reading to learn about how to monitor osteoporosis treatment, including the goals of various medications and when to consider switching to a different drug.

A bone density test can help determine whether your osteoporosis medication is working and helping to achieve your treatment goals.

This test uses dual-energy X-ray absorptiometry (DEXA), a quick, painless process that involves lying on a table as an imaging arm moves over your body. You probably had this scan before you received an osteoporosis diagnosis.

Doctors typically recommend getting a bone density scan a few years after starting treatment, but this can vary from person to person and depending on which medication you’re taking.

A doctor might also recommend blood and urine testing to help evaluate the effectiveness of your treatment.

Here are some signs that your osteoporosis treatment is working:

  • Your bone density has not decreased.
  • You have not had further bone loss.
  • You have not had any new fractures.

Osteoporosis treatment is typically recommended for postmenopausal women with:

  • a bone mineral density T-score of -2.5 or less
  • an increased risk of fracture
  • a history of spine or hip fracture

There are two main categories of osteoporosis medications that can help lower the chances that you’ll break a bone: antiresorptives and anabolic agents.

Antiresorptives

Antiresorptive medications treat osteoporosis by slowing the process your body uses to break down old bone. They help prevent you from losing more bone mass.

Bisphosphonates are the most common antiresorptive medications used to treat osteoporosis. These include:

  • alendronate (Fosamax)
  • ibandronate (Boniva)
  • risedronate (Actonel, Atelvia)
  • zoledronic acid (Reclast, Zometa)

Bisphosphonates are generally well tolerated as a first-line therapy. If these drugs don’t work, a doctor may recommend another type of antiresorptive medication, such as:

  • denosumab (Prolia, Xgeva)
  • calcitonin (Miacalcin)
  • estrogen/estrogen-progestin
  • raloxifene (Evista), a selective estrogen receptor modulator
  • estrogen/bazedoxifene, a tissue-specific estrogen complex

Anabolic agents

Anabolic agents stimulate new bone formation, which can strengthen bones. These medications are typically recommended for people with severe osteoporosis who have not seen results from other medications.

Anabolic agents used to treat osteoporosis include:

  • teriparatide (Bonsity, Forteo), a parathyroid hormone analog
  • abaloparatide (Tymlos), a parathyroid hormone-related protein analog
  • romosozumab (Evenity), a sclerostin inhibitor

Many osteoporosis medications are available in pill form, but others require injections or intravenous (IV) infusions.

Depending on the specific drug, your osteoporosis treatment may need to be administered on one of the following schedules:

  • daily
  • weekly
  • monthly
  • annually

Like any other medication, osteoporosis treatments come with the risk of side effects. A doctor can explain the potential benefits and side effects of each medication and recommend an osteoporosis treatment for you.

Osteoporosis treatment will not cure or reverse the disease, but that doesn’t mean it’s not working. The goal of treatment is to reduce the risk of fractures and support bone health.

The two types of medication have different treatment goals. Antiresorptive medications are used to prevent further bone loss. The goals of anabolic agents for osteoporosis include:

  • rebuilding bone
  • repairing microscopic damage in bone
  • boosting bone mass

Following your treatment plan as prescribed by a doctor increases the likelihood that it will help your osteoporosis.

If your osteoporosis treatment is not working, your doctor may recommend trying a different medication based on a variety of factors, such as:

  • your risk of fracture
  • your overall health
  • your preferences
  • the potential side effects and risks of the drug

You may also need to switch osteoporosis medications if the drug you’re currently taking causes side effects.

Talk with your doctor about the risks and benefits of various medications and whether you should consider trying a different treatment.

In addition to taking osteoporosis medication, changing your diet and lifestyle can support your bones and reduce the risk of fractures.

Calcium and vitamin D play an important role in bone health, so it’s important to make sure you’re getting enough of these nutrients. The National Institutes of Health recommends:

Depending on your diet and your overall health, your doctor may recommend different doses.

Calcium can be found in a variety of foods, including seeds, dairy products, beans, and sardines. Vitamin D is also found in some foods, such as salmon, egg yolks, and mushrooms, but it’s primarily produced inside our bodies when we’re exposed to sunlight.

If you’re not getting enough calcium or vitamin D through your diet, your doctor may recommend taking an over-the-counter supplement.

If applicable and accessible to you, lifestyle strategies such as the following can also help reduce the impact of osteoporosis:

  • Perform weight-bearing exercises regularly.
  • Cut down on alcohol and caffeine.
  • Quit or avoid smoking.
  • Reduce tripping hazards and improve the lighting in your home.
  • Install grab bars or handrails where you need them.
  • Use an assistive device, such as a cane or walker, if it helps you feel more stable.
  • Wear shoes that provide good grip and support.
  • Stay socially active and involved. Social interactions may lift your spirits.

Postmenopausal osteoporosis doesn’t only affect your bones — it can also affect your mental health. If you feel anxious or depressed or simply need some extra emotional support, consider talking with a mental health professional. An osteoporosis support group can also be a great option for emotional support.

Postmenopausal osteoporosis can be treated with several medications, including antiresorptives (like bisphosphonates) and anabolic agents. Bone density scans can help doctors determine whether your osteoporosis treatment is working.

If your current treatment is not working, your doctor may recommend switching to a different medication. Your overall health and preferences should be part of the equation when you’re choosing medications. It’s also important to discuss the possible side effects of each medication.

There’s no one-size-fits-all treatment plan for postmenopausal osteoporosis. In addition to medication, diet and lifestyle strategies can be helpful for improving bone health and reducing the chances of a fracture.

If you’re concerned about the effectiveness of your osteoporosis treatment, get in touch with your doctor.