What is the primary treatment for osteoporosis in older women?

Bisphosphonates are considered the primary treatment for osteoporosis in older women due to their effectiveness in reducing the risk of fractures. Osteoporosis is characterized by decreased bone density and strength, which significantly increases the likelihood of fractures, particularly in postmenopausal women who experience a rapid decline in estrogen levels contributing to bone loss.

Bisphosphonates work by inhibiting osteoclast-mediated bone resorption, thus helping to maintain or increase bone density. Common examples include alendronate and risedronate. These medications have been shown to effectively lower the incidence of vertebral and non-vertebral fractures in clinical studies, making them a cornerstone in the pharmacologic management of osteoporosis.

While calcium and vitamin D supplements play important roles in bone health and are often used to support the treatment regime, they do not have the same direct impact on reducing fracture risk in those who already have osteoporosis. Furthermore, while estrogen replacement therapy can help in preventing postmenopausal bone loss, it is not considered the first-line treatment due to concerns over cardiovascular health and breast cancer risks.

In summary, bisphosphonates are the most effective and commonly prescribed medications for the treatment of osteoporosis in older women, addressing the underlying pathophysiology of the