Osteoporosis is a condition that results from progressive loss of bone mass, leading to weakening of bone strength and increased risk of fracture. Osteopenia is when there is less than optimum bone mass or bone density, but the situation is not quite osteoporosis.
Both of these diagnoses can be confirmed by bone density measurement on a piece of equipment called the DXA (pronounced dexa).Bone is living, dynamic tissue whose strength and size is determined by the balance between two types of cells: osteoblasts (which build bone) and osteoclasts (which break down bone).

During childhood growth, osteoblasts take the lead over osteoclasts, resulting in bone growth. After menopause, and with some other medical conditions, osteoclasts overpower osteoblasts, leading to loss of bone.
Medications that help to improve that balance fall into two categories: antiresorptive agents and bone-forming agents.Antiresorptives work by decreasing the effects of osteoclasts on bone breakdown (called bone resorption). These medications include hormone replacement therapy, bisphosphonates (Fosamax, Actonel and Boniva), hormonelike agents (Evista), and a nose spray (Miacalcin, Fortical).

This category of medications can be very effective in preventing bone loss.
There is no clear answer on how long they should be taken, but osteoporosis experts are trying to draw some conclusions about that very question.There is currently only one medication in the bone-forming category, but others are expected in the near future. Forteo is an injectable medication that resembles a hormone made by the body called parathyroid hormone. It is self-injected directly under the skin daily for a total of two years. This medication is quite effective for those with a very high risk of fracture.

Medications alone are not sufficient to prevent and treat osteoporosis. Calcium and vitamin D are critical building blocks for preserving bone health. Important lifestyle measures include weight-bearing exercise and avoidance of smoking and excessive alcohol use.