Midlife Meds

Osteoporosis Drugs

Why You Would Want Treatment: Bone density is hormone regulated and can decrease after menopause. If a bone scan reveals you have osteoporosis, you may be a candidate for treatment. Bisphosphonate drugs (Fosamax, Actonel) inhibit skeletal breakdown, resulting in maintained or increased bone density and strength. Selective estrogen receptor modulators (SERMs) like Evista offer another approach, acting as estrogen stand-ins to preserve and build bone.

Drawbacks: Bisphosphonates may cause stomach upset, ulcers, bone, joint, and muscle pain, headaches, and, rarely, jaw osteoporosis. SERMs can trigger hot flashes, leg cramps or swelling, blood clots, and flu-like symptoms.

Ask Your Doctor: ...to consider your risk of breast cancer; SERMs have been linked to a reduced risk of breast cancer in postmenopausal women. Discuss all the other ways you can protect bone, such as regular exercise (especially resistance training) and calcium and vitamin D pills (many doctors suggest 1,200 to 1,500 milligrams and 800 to 2,000 IU per day, respectively).

Cholesterol Medications

Why You Would Want Treatment: As hormones decrease and metabolism slows with age, the body processes cholesterol less efficiently. If the fats build up in your artery walls, they can restrict blood flow, increasing the risk of heart attack and stroke. Statins help lower cholesterol production in the liver. Other types of drugs include resins (which help the body dispose of cholesterol), selective cholesterol absorption inhibitors, niacin, and fibrates.

Drawbacks: Statin side effects include muscle aches, gastrointestinal disturbances, skin rash, and, occasionally, liver problems. Resins may cause bloating and constipation. Fibrates can cause nausea. Niacin may lead to flushing and stomach upsets.

Ask Your Doctor: ...if she thinks there are any lifestyle changes you could make first to lower cholesterol. If you begin treatment, be sure to clarify that it's to raise HDL ("good" cholesterol) and lower LDL ("bad" cholesterol) levels: The ratio of good to bad cholesterol is a better predictor of your cardiovascular health than total cholesterol.   

Hypertension Medications

Why You Would Want Treatment: Your hormones help keep blood pressure low, which may help explain why it typically rises after menopause—when women become more at risk for hypertension than men. Beta-blockers, ACE inhibitors, calcium channel blockers, and similar drugs relax blood vessels, giving blood more room to flow and thereby reducing risk for heart attack and stroke.

Drawbacks: Common side effects of beta-blockers and calcium channel blockers include fatigue and dizziness. ACE inhibitors may cause coughing and headache.

Ask Your Doctor: ...how low your blood pressure needs to drop, and how often you should come in for follow-up. Also ask about whether you should increase physical exercise as well as lower your intake of salt, caffeine,alcohol, and fat, all of which can raise blood pressure.

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