Postmenopausal women should take 1,500 mg of calcium daily. To assure adequate intake, prescribe a daily supplement of calcium carbonate, which should be taken with meals, or calcium citrate, which can be absorbed in the fasting state. 20-22 Estrogen, alendronate, and calcitonin are recommended to treat the disease. BMD in older women. The major side effects associated with estrogen use include breast tenderness, bloating, risk of thrombophlebitis, and resumption of menstrual flow when estrogen and progesterone are given cyclically.
Most women prefer a combination of estrogen and progesterone.
Vaginal spotting may occur during the first 6 months but then usually ceases. With alendronate, BMD is maintained for at least 2 years after the drug is discontinued. 28 Start the patient on 10 mg of alendronate daily. The drug should be taken with 8 oz of water at least 30 minutes before breakfast. The major side effects associated with therapy are heartburn and dyspepsia.