Osteoporosis is a common problem among postmenopausal women. It is a disease that results in progressive bone loss, and the risk of hip fracture for women aged between 50 and 90 increases 50 fold, while the risk of vertebral fracture increases 15 to 30 fold.

Both diet and moderate exercise have been scientifically proven to be very effective in combating osteoporosis.

Those who would rather not take direct control of their own health might prefer to try the drug Fosamax (alendronate sodium). Alendronate binds to the bone while restricting the effects of osteoporosis, although it does slow the growth of new bone. This means your body doesn't have the bone turnover that it would before the menopause.

The manufacturer, Merck, has recently been trumpeting the virtues of Fosamax following on from the FIT (Fracture Intervention Trial) which involved 2,027 postmenopausal women (Lancet, 1996; 348: 1535-41). The trial showed that the drug reduced hip fractures by 51 per cent and new vertebral fractures by 47 per cent. Equally impressive, it has similar adverse reactions to placebo.

A trial in the US, among 1,800 postmenopausal women, came to similar conclusions about its safety. However, 4.1 per cent of patients had to stop treatment because of adverse reactions, which included abdominal pain, nausea, dyspepsia, and musculoskeletal pains.

Women with kidney problems have been warned not to take the drug, mainly because the body will not be so efficient in processing it, and too much may stay in the system.

Merck recommends that patients should also maintain an "adequate" calcium diet. They might also have suggested a good exercise regimen as well perhaps then their patients may not even need the drug.