Osteoporosis, osteopenia screening and prevention are best done when we're older
Most healthy women can wait until they are 65 to be checked for bone loss instead of 50. Drug therapy, its long-term effects unknown, can also wait.
Pete Saloutos / Corbis
JUST A few years back, it was heresy to suggest that, when it comes to protecting bones, early treatment may not be the answer.
Part of the rite of passage through menopause a decade ago became bone-density screening. Around age 50, many women would position their skeletons under the X-ray eye of new machines that could calibrate the alarming rate at which their bones were being eaten away. On top of that, they began to hear commercials featuring women, often much younger than they, praising a pill for saving them from nursing homes, physical deterioration and crumbling spines.
It was no longer sufficient to get enough calcium and vitamin D and do weight-bearing exercise. Suddenly, there were drugs available, Fosamax being the first in 1995 of a class called bisphosphonates, that could put that lost bone density back, help prevent painful, even deadly, fractures and reduce the number of women going through old age with crooked backs.
Osteoporosis: In Monday's Health section, an article on osteoporosis and drugs known as bisphosphonates incorrectly said that the original treatments required patients to eat before taking the drugs. In fact, originally -- as now -- the daily form of the drugs should be taken on an empty stomach first thing in the morning with a full glass of water -- not juice or coffee.
Osteoporosis: A Sept. 22 article on osteoporosis and drugs known as bisphosphonates incorrectly described how the pills should be taken. The article said that, originally, patients had to eat before taking the drugs. In fact, originally -- as now -- the daily form of the drugs should be taken on an empty stomach first thing in the morning with a full glass of water, not juice or coffee.
Confused about what the new label actually meant, young, healthy women suddenly seemed more worried about their bones than did their mothers and grandmothers -- who really had something to worry about. "Women don't understand what their risk is, one way or the other," says Dr. Ethel Siris, director of the Toni Stabile Osteoporosis Center of Columbia University Medical Center in New York.
Things have changed.
Studies have shown that most women will lose no more than 7% of their bone mass within the decade after menopause. Bisphosphonates have been shown to replace about 8% of bone within five years, so waiting will cost most women nothing. Counter to just about every other preventive healthcare message out there, when it comes to osteoporosis drugs, it's probably better to hold off. "Wait until the risk gets high enough," says Dr. Bruce Ettinger, adjunct clinical investigator at Kaiser Permanente, Northern California.
