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Medical Author:

Mythili Seetharaman, MD

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Once a diagnosis of osteoporosis or osteopenia is determined, the doctor may talk about medications available to treat bone loss. The goal of treatment is to prevent the development of osteoporosis (if decreased bone mass or other risk factors are present) and to prevent further bone loss (especially if osteoporosis has already been diagnosed). The bottom line is to preserve the bone mass and density present to decrease the risk of fractures, disability, and mortality. The many treatments available today have been shown to work quickly (within one year), and they reduce the risk of fracture by up to 50%. The choice of treatment should fit a person's specific medical needs and lifestyle, so talking to the doctor is important.

• Alendronate (Fosamax) and risedronate (Actonel) are approved for treatment of osteoporosis in men as well as for steroid-induced osteoporosis.
• Zoledronic acid (Reclast) IV is also approved to treat osteoporosis in men.
• Teriparatide (Forteo) SQ contains a portion of the parathyroid hormone (PTH) molecule and has been shown to increase bone density of the spine in men. It is administered as a daily injection that is approved for men with hypogonadal (low testosterone) osteoporosis.
• Although many medications are prescribed to treat osteoporosis in women, currently they are not approved by the Food and Drug Administration (FDA) for use in men, but investigational studies in men are in progress.
• To help men with osteoporosis and low testosterone, doctors may recommend testosterone replacement therapy. In men, testosterone results in a small but significant increase in bone density. Calcitonin is another medication that slows or stops bone loss and may relieve the pain of fractures in some patients. Calcitonin is approved by the FDA for the treatment of osteoporosis in postmenopausal women. It has not been studied in men, but evidence suggests that it may work the same in men as in women. Calcitonin is available as an injection and as a nasal spray.

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