Should I have a drug treatment?

Osteoporosis drug treatments are prescribed to help strengthen and protect your bones, making you less likely to break a bone in the future. But some people worry about starting a new drug treatment and find it hard to make a decision.

For example, you might be concerned about possible side effects or health risks, or wonder if you really need treatment. Or you might not like taking medication in general.

It’s your choice whether to have a drug treatment or not. The information on this page aims to help you think things through and make a decision that's right for you.

Why do I need a drug treatment?

Doctors follow guidelines when deciding whether to offer treatments. If you've been offered a drug treatment, this means your risk of breaking a bone is high enough that your bones would benefit from this type of medical help. For you, the benefits of taking a drug treatment are likely to outweigh any possible risks. In other words, your risk of health problems if you do have treatment is smaller than your risk of breaking a bone if you don’t have treatment.

Your doctor will have considered lots of things before recommending a drug treatment, including:

• how likely you are to break a bone without treatment
• what type of treatment (tablets, injections or a drip) would be suitable for you
• whether you've already had a drug treatment for your bones
• any other health problems you have
• any other medications you take
• the treatments available at your local hospital or GP surgery
• your own thoughts and feelings about treatment.

There are several treatments available for osteoporosis and weaker bones, but they may not all be suitable for you. For example, some tablets have to be taken daily, which isn’t ideal for everyone. Some drugs are usually only available if you’ve already tried other drug treatments, or if other medications aren’t suitable for you. And in some areas, local guidance means doctors can only prescribe certain drugs.

If you have any questions about the drug treatment you’ve been offered, speak to your doctor. They can explain why they’ve recommended that drug and tell you about any other treatments that might be suitable.

What will happen if I don’t have a drug treatment?

If you decide not to take a drug treatment, it is likely that your bones will get weaker over time. This means your chance of breaking a bone will increase.

Some people may never break any bones, while others may break several. Everyone’s risk is different, so it’s important to understand your own situation and make the decision that’s right for you.

Is there a natural alternative to medication?

People often want to know if they can improve their bone strength without taking a drug treatment. The following lifestyle changes are all important for your bones. But if you have a high risk of broken bones, there isn’t good evidence that any non-drug approaches will improve your bone strength enough to reduce the chance of breaking a bone.

• A well-balanced, varied and calcium-rich diet
• Safe exposure to sunlight, so that your skin makes vitamin D
• Regular weight-bearing impact exercise and muscle-strengthening exercise
• Not smoking
• Not drinking more than the recommended levels of alcohol
• Taking steps to lower your risk of falling, as falls can lead to broken bones

As well as taking a drug treatment, your doctor may advise you to:

• aim to consume around 1,000mg of calcium a day
• take a daily 20 microgram (20µg or 800 IU) supplement of vitamin D.

This is more than the usual recommended amount, to make sure you are getting enough for your bones. Your doctor may sometimes recommend higher or lower doses, depending on your own situation. However, supplements are not an alternative to taking a prescribed drug treatment for your bones.

Making a decision about treatment

It’s important to learn all you can about your treatment options, so you can decide what’s right for you. Talk to your doctor so that you fully understand your situation. Make sure you read – and understand – any information they give you, as well as the patient information leaflet that comes with the treatment. If you don't have a copy, ask your doctor or pharmacist for one.

No-one can make you have treatment if you don’t want it. But do take the time to understand the benefits and possible risks – both of taking a drug treatment, and of not taking one.

Take care when visiting online forums or chat groups on social media. Reading about other people’s experiences can be helpful. But you may not always see a balance of views online. People are more likely to seek support for bad experiences than good ones. This can make it seem that everyone has problems with drug treatments. In reality, most people have no side effects at all.

If you do feel worried or uncertain, before or during your treatment, talk to your doctor or pharmacist, or contact our specialist Helpline nurses.

Content reviewed: March 2023

Read next:

• Which medication should I take?

Watch our webinar on osteoporosis drug treatments:

If you're thinking about taking a drug treatment for osteoporosis, you may be interested in watching a conversation between osteoporosis experts Dr Nicola Peel, Dr Zoe Paskins and Professor David Armstrong, who discussed drug treatments in May 2022 as part of our #BoneMatters series of events.