Treatment for osteoporosis can be lifestyle improvements in the form of an exercise and vitamin regimen, or a GP may prescribe medication, or a combination of both.
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All medications can have possible side effects. Always speak to your GP about any drug treatments you plan to take.
Bisphosphonates slow down the rate at which bone is broken down. This helps maintain bone density and reduces the risk of fracture. They are the most commonly used osteoporosis medicines. Examples are alendronic acid, risedronate, ibandronic acid and zoledronic acid. They can be taken as a tablet or liquid, or given as an injection or a drip (infusion).
Tablets must be taken exactly as instructed: on an empty stomach with a full glass of water, staying upright for at least 30 minutes afterwards. Possible side effects include irritation of the food pipe, swallowing problems and stomach pain. A rare side effect is osteonecrosis of the jaw, which is seen mostly with the high doses used in cancer care. Tell your dentist you take a bisphosphonate, and have any dental check-up you need first.
See NICE guidelines to bisphosphonates
Denosumab is an injection given every six months. It is a biological (antibody) medicine that slows down bone breakdown. Denosumab should not be stopped or delayed without a plan from your doctor, because stopping it suddenly can lead to rapid bone loss and a higher risk of spinal fractures. Usually another medicine is needed afterwards.
Romosozumab is a biological medicine given as monthly injections for 12 months, usually followed by another osteoporosis medicine. It both helps build bone and slows bone breakdown. In England, NICE recommends it for some people with severe osteoporosis after the menopause who have had a major fracture in the past two years. It isn't suitable for people with a history of heart attack or stroke.
Teriparatide and abaloparatide are forms of parathyroid-hormone-related treatment that stimulate the cells that build new bone. They're daily self-injections for a limited period, followed by another medicine to keep the benefit. Specialists usually use them for people at very high risk of fracture, for example with very low bone density or several fractures, or when other treatments are not suitable.
Raloxifene acts like oestrogen on bone. It helps maintain bone density and reduces the risk of spinal fractures. It is only used for women after the menopause. Possible side effects include hot flushes, leg cramps and a small increased risk of blood clots.
HRT helps with menopause symptoms and has been shown to keep bones strong and reduce the risk of osteoporosis. Women whose menopause starts before 45 are usually advised to take HRT, or a hormonal contraceptive, until at least age 51 unless there's a reason not to. HRT has some risks, which depend on the type, your age and your health, so discuss them with your GP. See our page on menopause and your bones.
If tests show that low testosterone is contributing to bone loss in a man, a specialist may consider treating it as part of his care. Testosterone isn't a routine osteoporosis treatment on its own.
You may see calcitonin in older information. In 2012 UK regulators advised that calcitonin should no longer be used to treat osteoporosis, because long-term use was linked with a small increased risk of cancer. The nasal spray was withdrawn for this use.
See also Exercises for Bone Health
Weight bearing is important for both preventing and treating osteoporosis. Any exercise where muscle overcomes a resistant force – including gravity – staves off age-related declining muscle mass and grows new muscle. Adults aged 65 and over are advised to do activities that improve strength, balance and flexibility on at least two days a week, alongside regular moderate activity.
If you have osteoporosis or have broken a bone, ask your GP or a physiotherapist which activities are right for you before starting high-impact exercise.
Rebounding means jumping up and down on a mini trampoline and is a popular low-impact activity. Some trampettes come with a handle for those who would like extra support. Start off gently and be mindful of your joints – if you have been diagnosed with osteoporosis or low bone density, consult a healthcare professional before beginning rebounding to ensure it is suitable for your spine and fracture risk.
The benefits of vibration therapy are yet to be firmly established. Standing on a vibrating platform was explored to help astronauts maintain bone mass, but research into its effectiveness in osteoporosis remains unclear. Vibration therapy should not replace proven medical treatments or conventional exercise.
See also Adults and Bone Health
Vitamin D helps the body absorb calcium, which is essential for bone strength.
Consult your GP for guidance on supplements if you are unsure of your needs.
Smoking is directly linked with reduced bone density and an increased risk of fractures. Free help is available via the NHS Stop Smoking service.
Heavy alcohol consumption impairs bone building and raises the risk of falls. Follow the low-risk guideline of no more than 14 units a week, spread evenly across three or more days. See the NHS Alcohol Support page.
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Last clinically reviewed: October 2026 by Dr Taher Mahmud FRCP, Consultant Rheumatologist. Next review due: October 2027. This page gives general information only and doesn't replace advice from your own doctor.