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.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Osteoporosis facts
- What is osteoporosis?
- What are osteoporosis symptoms and signs?
- What are the consequences of osteoporosis?
- Why is osteoporosis an important public health issue?
- What factors determine bone strength?
- What are osteoporosis risk factors and causes?
- How is osteoporosis diagnosed?
- Who should have bone density testing?
- What is the treatment for osteoporosis, and can osteoporosis be prevented?
- Exercise, quitting cigarettes, and curtailing alcohol
- Calcium supplements
- Vitamin D
- Hormone therapy (hormone replacement therapy, menopausal replacement therapy)
- Medications that prevent bone loss and breakdown
- Choosing an osteoporosis medication
- Prevention of osteoporosis caused by long-term corticosteroids
- Monitoring osteoporosis therapy medication
- Prevention of hip fractures in elderly people with osteoporosis
- What are complications of osteoporosis?
- What is the prognosis (outlook) for patients with osteoporosis?
- Osteoporosis FAQs
- Find a local Internist in your town
Hormone therapy (menopausal hormone therapy)
Estrogen hormone therapy after menopause (previously referred to as hormone replacement therapy or HRT) has been shown to prevent bone loss, increase bone density, and prevent bone fractures. It is useful in preventing osteoporosis in postmenopausal women. Estrogen is available orally (Premarin, Estrace, Estratest, and others) or as a skin patch (Estraderm, Vivelle, and others).
Estrogen also is available in combination with progesterone as pills and patches. Progesterone is routinely given along with estrogen to prevent uterine cancer that might result from estrogen use alone. Women who have had a hysterectomy (surgical removal of the uterus) may take estrogen alone since they no longer have a uterus to become cancerous. Nasally delivered estrogen and lower-dose combination pills of estrogen and progesterone are also being studied. However, due to adverse effects of HRT, such as increased risks of heart attack, stroke, blood clots in the veins, and breast cancer; HRT is no longer recommended for long-term use in the therapy of osteoporosis. Rather, HRT is used short term to relieve menopausal hot flashes.
Every woman needs to have an individualized discussion regarding HRT with her doctor because each woman will place different weight on the risks and benefits of the treatment.
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