How can you decide about taking bisphosphonate medicine for osteoporosis?

Osteoporosis is a common disease, and it affects women and men. In Canada, 1 out of 3 women and 1 out of 5 men have osteoporosis. For every 100 people in Canada who break a bone, less than 20 will have a bone density test or get treatment for osteoporosis.

What is osteoporosis?

Osteoporosis is a disease that affects your bones. It means you have bones that are thin and brittle and have lots of holes inside them. This makes them easy to break. It can lead to broken bones (fractures), especially in the hip, spine, and wrist. These fractures may make it hard for you to live on your own.

Bisphosphonates are the most common medicines used to prevent bone loss. They may be taken as a pill or an injection into a vein. Bisphosphonates slow the way bone dissolves and is absorbed by your body. They can increase bone thickness and strength and reduce the risk of broken bones.

What are key points about this decision?

• If you are at a higher risk of having a fracture, taking bisphosphonates is more likely to help you prevent a fracture. If your risk of a fracture is lower, it's less likely that these medicines will help you.
• Bisphosphonates can cause problems with the jawbone or thigh bone. But most people do not have these side effects.
• Whether you take medicine or not, healthy habits can help protect your bones. Get enough calcium and vitamin D. Do regular weight-bearing or resistance exercises. If you drink alcohol, try to drink less. Work with your doctor to find what is right for you. And if you smoke, try to quit. Talk to your doctor if you need help quitting.

Who is helped the most by bisphosphonates?

• Bisphosphonates will lower your risk of fracture if you have osteoporosis, or you have had a fracture in your hip or spine.
• Bisphosphonates may help if you have low bone density, and you are at a high risk for a fracture or have had a fracture in certain places, including your upper arm or pelvis.

What are the side effects of bisphosphonates?

These medicines can have side effects, such as heartburn and stomach upset. They can also cause a fever and body aches for a few days after you start the medicine.

Certain problems with the jawbone and fractures of the thigh bone have been reported in a very small number of people. The risk of fracture from not treating osteoporosis is higher than the risk of these side effects.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.