Hope for control, however, is in sight. Bone is continually laid down and also resorbed. In ten years the entire skeleton is rebuilt. There is an age related decline in total bone tissue in both men and women but women start with a lower total bone mass. The loss in women is accelerated after the menopause with the loss of estrogen production.
Treatment is directed at increasing bone formation or decreasing bone resorption.
Vitamin D is not a standard recommedation because it can cause high blood and urine calcium. Exercise, especially bone vibrating and weight bearing, helps lay down bone especially in teenaged girls. Side effects such as weight gain, breast tenderness, and menstrual periods decreases compliance in elderly women. Since 1990 bisphosphonates have been found to shut off bone resorption. They both can irritate and even ulcerate the lower esophagus if not taken when upright with a full glass of water and at least a half hour before food or even orange juice.