On the one hand, bone is built in response to stresses such as weight-bearing and muscle strength. On the other hand, bone is also lost in response to hormonal activity and lack of weight-bearing stress on the bones.
In young adults the difference between bone growth and loss is on the positive side. This means that up until an individual reaches age 30 they are laying down more bone van is being destroyed.
After 35 bone is lost progressively faster than it is being built. Over the past 15 years researchers have been on a quest to discover medications and therapies that will either hinder the loss of bone or increased bone building activity, all in an effort to decrease the negative effects for individuals who suffer from osteoporosis.
In 1997 the Federal drug administration granted permission for Eli Lilly & Co. to market raloxifene (Evista) for the prevention of osteoporosis. Evista was heralded as an alternative to estrogen and hormone replacement therapy for postmenopausal women who needed preventative therapy for osteoporosis and coronary heart disease. Although estrogen was a great preventative measure it also carried a greater risk for breast, uterine and ovarian cancers. Although taking progesterone with the estrogen will reduce the risk it doesn’t totally eliminate it.
As a life expectancy of women continues to increase researchers are finding that many women will spend as much as one third of their lives after menopause efficient in estrogen and at a greater risk for osteoporosis. New medications, therapies and preventative measures continue to be sought since osteoporosis places a huge medical and financial burden on society. Researchers also recognize that many individuals are not willing to make a lifestyle choices and dietary adjustments in order to ensure adequate bone growth and prevention of osteoporosis.
Thus, Evista may be the next great hope for postmenopausal women who require help with prevention for osteoporosis. Evista belongs to a new class of drugs called selective estrogen receptor modulator’s and appears to be able to act like estrogen on certain tissues but not others.
The first selective estrogen receptor modulator drug to reach the market was tamoxifen used in women diagnosed with breast cancer to prevent cancer and the second breast. Other similar drugs have followed. In several studies Evista was shown to increase bone mass, prevent osteoporosis and lower total LDL in the fight to prevent coronary artery disease.
However, there are a number of negative side effects that go beyond generalized hot flashes and mild leg cramps. Some of the more serious risks include Venus clots that break off and can cause a pulmonary embolism. There is a 2.5 increased risks to those clots in people taking Evista. There is no evidence that Evista will prevent heart disease. Although it lowers LDL it fails to change the HDL levels or triglyceride levels, all of which are needed in order to prevent coronary artery disease.
Although medications such as Evista are important in the fight against osteoporosis they are not the only measures that women can take to prevent post-menopausal changes. Physicians will continue to recommend that women decrease any excess of alcohol intake, stop smoking, increase their calcium, and vitamin C and vitamin K2 intake as well as include weight-bearing exercises in their daily routines.
And to more recent studies the effectiveness of the best was called into question. In both studies of drugs was not shown to have a significantly positive effect on increasing bone mass density and in one study researchers determined that Fosamax showed greater improvement than did the Evista.
Only you and your physician can make the decision about the types of medications and therapies that will best fit your particular lifestyle. The choice should be made only after a thorough physical examination, medical history, social evaluation and consultation with the individual about the types of changes to the lifestyle that will be attempted. Evista may be the course of action you choose him but it should only be done using an informed choice.
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