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Home · Symptoms + treatments

Bone loss (osteopenia / osteoporosis): treatments compared (2026)

Estrogen loss accelerates bone resorption. Early intervention prevents irreversible loss.

What it is

Women lose ~10% of bone density в the 5 years around menopause. ~50% of postmenopausal women will fracture а bone due к osteoporosis в their lifetime.

Who experiences this

All postmenopausal women face risk. Higher: thin frame, smoking, family history, early menopause (<45), corticosteroid use.

Treatment options compared

All options below are real published treatments. Evidence-level reflects current clinical guidelines (NAMS / ACOG / Endocrine Society). Cost ranges are starting price estimates от $US public sources.

Systemic estrogen (preventive)

HRTfirst lineFDA-approved

Monthly cost

$25-$150

Side effects

breast tenderness, spotting

FDA-approved для osteoporosis prevention в postmenopausal women с VMS. Preserves bone density when started early. Effect reverses on discontinuation.

Providers offering this: midi health, alloy womens health

Bisphosphonates (alendronate, risedronate)

Non-hormonalfirst lineFDA-approved

Monthly cost

$10-$40 generic

Side effects

esophageal irritation, rare jaw osteonecrosis с long-term use

First-line для established osteoporosis. Reduces vertebral fractures ~50%. Strict dosing requirements (empty stomach, 30 min upright).

Contraindications: Esophageal stricture, severe renal impairment

Denosumab (Prolia)

Non-hormonalsecond lineFDA-approved

Monthly cost

$1500 per 6-month dose

Side effects

hypocalcemia, rare jaw osteonecrosis

SubQ injection every 6 months. Useful когда oral bisphosphonates contraindicated. Discontinuation can cause rebound bone loss + fractures — plan transition.

Calcium + vitamin D supplementation

Lifestyleadjunct

Monthly cost

$5-$20 OTC

Side effects

constipation, kidney stones if excessive

Calcium 1200mg/day + vitamin D 800-1000 IU. Supplements alone не sufficient when osteoporosis established.

Weight-bearing exercise + strength training

Lifestylefirst line

Monthly cost

$0-$50

Side effects

minimal

Walking, jogging, resistance training stimulate bone formation. Required regardless of pharmacotherapy.

When к see а clinician

  • DEXA scan recommended at age 65 (sooner if risk factors)
  • Loss of height >1 inch
  • Fragility fracture (fall от standing height)
  • Early menopause (<45) — earlier DEXA + treatment consideration

FAQ

When should я get а DEXA scan?

Routine at age 65. Earlier (50-64) if: family history of hip fracture, early menopause, long-term corticosteroid use, BMI <19, smoking, alcohol >3 drinks/day, или previous fragility fracture.

Sources

Last verified 2026-06-01. Treatment guidelines update — confirm с your clinician.