Osteoporosis medicines work by:

• slowing the breakdown of bone – for example, bisphosphonates, denosumab and raloxifene (antiresorptives), or
• increasing the production of new bone – for example, teriparatide (an anabolic medicine).

As a result, they increase your bone strength and reduce your chances of fracture.

Hormone Replacement Therapy (HRT) may also be an option for some postmenopausal women. 

It is important to take your medicines for as long as your health professional advises, as it can take between 6 and 12 months before osteoporosis medicines start to reduce your risk of fractures. 

You will also need to use your osteoporosis medicines for a long time – 5 years or more (with the exception of HRT, which should be used as a short-term treatment of up to 5 years for women below the age of 60).

Some other medicines (including calcium supplements) and foods may interfere with your oral osteoporosis medicine and stop it from being properly absorbed. Your health professional will usually give you this information. If you aren’t sure what to do, it's worth asking.

For more information, see the consumer medicine information (CMI) for your brand of medicine, available on our Medicine Finder page or from your pharmacist or doctor.

References

1. Osteoporosis Australia. Hormone replacement therapy and osteoporosis. 2012 (accessed 19 August 2015).

Calcium and vitamin D work together to maintain bone strength, so it’s important to get enough of each.

Calcium

Most people require 3 serves of dairy per day to obtain enough calcium.

1 serve of calcium = 250 mL milk, 200 g yoghurt or 40 g cheddar cheese.

If you cannot eat dairy products or are unable to consume the adequate number of serves of dairy food each day, you may be able to get enough calcium by including other calcium-rich foods in your diet, such as:

• almonds
• baked beans or soy beans 
• calcium-fortified breakfast cereals 
• tinned salmon
• tofu.

Practical tips on your daily requirements and getting enough calcium in your diet are available on the Osteoporosis Australia website.

Only consider a calcium supplement when you have trouble getting enough calcium from your diet, and ask your doctor or pharmacist about a supplement and dose that suits you.

Vitamin D

Vitamin D is made by the body when bare skin is exposed to sunlight. Most people get enough vitamin D through short periods of sun exposure, but people who are vitamin D deficient or at high risk of deficiency may need a supplement. 

Whether you have osteoporosis or osteopenia, your doctor may advise you to make lifestyle changes, including:

• limiting your alcohol consumption
• stopping smoking
• doing weight-bearing and resistance forms of exercise. 

Specific types of exercise, particularly weight-bearing exercise and progressive resistance training, are important for improving bone strength. Weight-bearing exercise include jogging, aerobics and dancing. Examples of resistance training are lifting hand or ankle weights.

If you have osteoporosis you may need to avoid exercises that involve twisting, sudden movements or bending forwards from the spine. 

If you haven’t previously undertaken any physical activity, a low level exercise program is recommended. A physiotherapist or exercise physiologist can advise you on the most appropriate exercise program for your abilities and interest.

Find out more about lifestyle choices for better health.

References

1. Royal Australian College of General Practitioners. Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men. East Melbourne: RACGP, 2010 (accessed 11 August 2015).

Many fractures are caused by falls – people aged 65 years and older are most likely to be affected. Falls can cause serious injuries and damage self-confidence and independence.

• exercises to improve muscle strength
• 'fall-proofing' your house (eg, securing loose floor rugs and electrical or phone cords, using a non-slip mat for the bath or shower, fixing poor lighting)
• checking your vision
• ensuring the medicines you take are not affecting your balance
• checking your strength and whether a walking aid would help you.