Some drugs, such as corticosteroid and too much thyroid medication taken over long periods, may also put one at risk. Besides strengthening the entire skeleton, halving the risk of hip fracture and reducing the risk of spinal fraction by up to 75 percent, HRT has the added benefit of protecting against heart disease and stroke. Unfortunately, it can also cause uterine bleeding and, over time, increase the risk of breast cancer. SERMs emulate the estrogen molecule with slight modifications designed to mitigate side effects. One of the first SERMs approved by the FDA for osteoporosis is raloxifene, which was introduced in 1997.
Studies show that raloxifene is effective in reducing bone fractures without causing bleeding.
However, it is not as effective as HRT and does not improve other symptoms associated with menopause, such as hot flashes. Another effective treatment is alendronate, one of the newest of a class of drugs known as biphosphonates, which has been available since 1995. Alendronate has been shown to reduce spine, hip and wrist fractures by 50 percent. However, it must be taken first thing in the morning every day, on an empty stomach, with a large glass of water while seated upright, in order to avoid heartburn. Calcitonin, a nasal spray treatment, has been shown to increase bone density in the spine, resulting in less pain and up to 40 percent fewer vertebral fractures.