For women with postmenopausal osteoporosis at high risk for fracture
Frequently Asked Questions About Postmenopausal Osteoporosis & TYMLOS
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Osteoporosis is a common yet serious bone disease that occurs when the body loses too much bone, makes too little bone or both. When this happens, bones weaken and may break from a fall from standing height or less. In severe cases, even a sneeze or minor bump can fracture a bone.
Postmenopausal osteoporosis is osteoporosis that occurs after menopause due to a decrease in estrogen levels. Estrogen is a key hormone in the bone-remodeling process and the drop in estrogen, often triggered by menopause, can lead to bone loss and postmenopausal osteoporosis.
Our bodies are constantly breaking down old bone and forming new, healthy bone. This is known as the bone-remodeling process. For women, estrogen helps regulate this process prior to menopause. However, estrogen levels decline after menopause, which causes women to lose bone more quickly. This imbalance in the bone-remodeling process can lead to postmenopausal osteoporosis — even in active postmenopausal women. Learn more about the bone-remodeling process.
Many other risk factors can impact bone health and quality, such as age, ethnicity and lifestyle. Get tough on postmenopausal osteoporosis and check out our list of common risk factors.
When your doctor measures your bone mineral density (BMD) you will get a “T-score.” These scores are determined through a bone mineral density test often referred to as a “DEXA” or “DXA” score or test. This number compares your BMD with the average BMD of young adults.
Healthy bone has a T-score of -1 and above. Osteopenia, the stage between healthy bone and osteoporosis, is indicated by a T-score of -1 to -2.4. Bone with a T-score less than -2.5 is considered osteoporotic. While a T-score is a useful guide, there are other factors your doctor may consider when determining your risk for postmenopausal osteoporosis:
Family history of osteoporosis
Osteoporosis is often considered a “silent” disease because you can’t actually feel bone loss. Some symptoms may include:
Shrinking or hunching otherwise known as “kyphosis”
Back pain caused by spinal fractures, also known as vertebral compression fractures (VCF)
A fragility fracture as a result of a movement or fall from a standing height or less that otherwise wouldn’t cause a break in healthy bone
If you’ve experienced menopause and have had a recent fracture, check with your healthcare team to see if you’re at risk for postmenopausal osteoporosis. You can also download our Doctor Discussion Guide for a list of questions that may be important to ask your healthcare team.
There are different types of treatments for postmenopausal osteoporosis. Antiresorptive medications help maintain the bone you have to reduce the risk of fracture. Anabolic medications, like TYMLOS, may help boost your body’s natural bone-building process by activating cells called osteoblasts. These cells normally form new, healthy bone through the remodeling process. With the help of anabolic medications, these cells work harder to replace the bone lost to postmenopausal osteoporosis. Learn more about anabolics.
There are many terms that can refer to a fracture caused by osteoporosis. An osteoporotic fracture is also referred to as a fragility fracture or low-impact fracture. It’s the result of a fall or strain that would not ordinarily result in a fracture. A fall from standing height or less that results in a fracture is one common example.
A spinal fracture, also known as a compression or vertebral fracture, is a fracture in the spine. This type of fracture can lead to height loss and kyphosis, or the hunching of the back. These are the most common types of fractures due to osteoporosis and can be symptomless, so they remain undetected. They can sometimes be associated with chronic back pain.
Your doctor is the best person to talk to in understanding your risk for fracture. But knowing some of the common risk factors can help drive your conversation. They include:
Smoking and alcohol
Never having been pregnant
The FRAX® Fracture Risk Assessment Tool is an easy online resource that can help you calculate your risk for fracture. You can access the FRAX tool here. If you wish to use the FRAX tool in another language, select from the drop-down menu on the right side of the top toolbar. If you'd like to see calculations based on nationality and ethnicity, use the “Calculation Tool.”
FRAX is a registered trademark of Centre for Metabolic Bone Diseases, University of Sheffield, UK.
Studies show that a diet rich in calcium and vitamin D and regular exercise makes for healthier bones, though sometimes it’s not enough. If you are concerned about whether or not your diet includes enough calcium and vitamin D, we recommend discussing it with your doctor.
Many different doctors treat osteoporosis. Primary care physicians and gynecologists know your medical history and lifestyle and may be the first people you discuss your risk factors with. They can treat postmenopausal osteoporosis, or they’ll refer you to a specialist if needed. These include rheumatologists, endocrinologists or orthopedic surgeons.
If you think you’re at risk for postmenopausal osteoporosis, it’s important to inform your healthcare team.
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TYMLOS is a prescription anabolic medication used to treat women with postmenopausal osteoporosis at high risk of fracture. An anabolic is a type of medication that may help boost your body’s natural bone-building process.
TYMLOS is used to decrease the chance of having a fracture of the spine and other bones in postmenopausal women with thinning and weakening bones (osteoporosis). Click here to read about our trial results.
TYMLOS may cause serious side effects, including possible bone cancer. Some animals developed bone cancer during testing, but it is not known if TYMLOS may cause bone cancer in people. Tell your healthcare provider if you have pain that does not go away, or any new or unusual lumps or swelling that is tender to touch.
Serious side effects could include a drop in blood pressure when changing positions and increased calcium in your blood or urine. The most common side effects include dizziness, nausea, headache, fast heartbeat, fatigue, upper stomach pain and vertigo.
These are not all the possible side effects of TYMLOS. Call your doctor for medical advice about side effects. You may report side effects to FDA at
Learn more about the side effects of TYMLOS.
TYMLOS is an anabolic medication for postmenopausal osteoporosis. This kind of medication is designed to help boost the natural process that builds new bone by activating cells called osteoblasts. These cells normally form new, healthy bone through the remodeling process. With the help of anabolic medications, these cells work harder to replace the bone you’ve lost to osteoporosis. Discover more on bone building.
TYMLOS is a prescription medication, so always start by consulting with your healthcare provider. Not sure which doctor to talk to? We’ve put together a list of some types of doctors who treat osteoporosis.
If your doctor prescribes you TYMLOS, you may get it through a “specialty pharmacy,” usually by mail. You may also be able to get it at a local pharmacy. Be sure to ask your doctor or staff at your doctor’s office about how you will receive your TYMLOS prescription, and if you should expect a call from a specialty pharmacy.
TYMLOS is a once-daily injection given in the stomach or abdomen.
Before first use, store TYMLOS pens in the refrigerator between 36°F and 46°F (2°C and 8°C). After first use, TYMLOS can be stored for up to 30 days at room temperature, between 68°F and 77°F (20°C and 25°C). You do not need to take it with food and it does not need to be refrigerated after first use.
You should receive your first several injections of TYMLOS where you can sit or lie down if necessary, until you know how it affects you.
For more on how to properly take TYMLOS, please refer to the Medication Guide and consult your healthcare provider.
Do not try to inject TYMLOS yourself until you or your caregiver receive training from a healthcare provider on the right way to use the TYMLOS pen. After that we recommend watching our instructional video on how to take TYMLOS. It will walk you through the process step-by-step.
You can also read the Instructions for Use document that outlines the steps to the injection here.
We also have a Clinical Educator Network where a caring osteoporosis educator can help guide you through the injection process, either live, over the phone or through video chat. You can call
The TYMLOS pen features a one-press button that injects the proper dosage. The pen uses a small needle that is 5 to 8 mm long, or approximately the length of an eyelash!
Compatible needles must be purchased separately. The correct needles to use with your TYMLOS pen are 5 to 8 mm, 31-gauge needles that include Clickfine®, BD Ultra-Fine™, MedtFine®, Easy Comfort, Clever Choice™ Comfort EZ™ and SureComfort™. If you are not sure what type of needle to use, ask your healthcare provider or pharmacist.
Please refer to our Instructions for Use for step-by-step instructions and for more information on the pen.
Our trained Clinical Educators can also provide guidance on how to give yourself the injection. You can find more information on our Clinical Educator Network here.
Unlike some medications, TYMLOS only requires refrigeration before first use. Before first use, store TYMLOS in the refrigerator between 36°F and 46°F. After first use, your TYMLOS pen can be kept at room temperature (between 68°F and 77°F) for up to 30 days. Read more about storing and traveling with TYMLOS.
If you forget or cannot take TYMLOS at your usual time, take it as soon as you can on that day. Do not take more than 1 injection in the same day. More information on taking TYMLOS can be found in the Medication Guide. For additional questions, consult with your doctor.
Since everyone’s dietary needs are different, it’s best to always consult with your doctor. He or she will determine if your calcium and vitamin D dietary intake is inadequate and if supplements are needed. TYMLOS can be taken with calcium and vitamin D.
It’s important to always inform your entire healthcare team, including your dentist, of any health changes, recent diagnoses or new prescriptions. Your dentist will decide what is best for your dental appointment, but typically you should not be required to stop taking TYMLOS for dental procedures.
You and your doctor will discuss what is next in your treatment plan. In the clinical study for TYMLOS, patients took TYMLOS for 18 months and then transitioned to alendronate, an oral generic bisphosphonate commonly prescribed to treat postmenopausal osteoporosis. Alendronate is also known as FOSAMAX®. Ask your doctor what is right for you.
FOSAMAX is a registered trademark of Merck & Co., Inc.
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Together with Tymlos is our patient support program that can help you as you begin your treatment journey. Patients can use it to check insurance coverage, connect with a specialty pharmacy and access trained Clinical Educators for injection support.
We also offer a savings program that may help eligible patients save on out-of-pocket costs. Eligible commercially insured patients may pay as little as $4 per month. Find out more about our Together with Tymlos support program, including eligibility information for our savings program.
Once you and your doctor decide TYMLOS is right for you, Clinical Educators are available to help you get started with treatment. They can help with things such as how to take your injection, what to expect on treatment and how to set goals to help you stay on your treatment for 18 months (or as directed by your doctor). Clinical Educators can help guide you through your first injection either live or virtually.
If you have a TYMLOS prescription and would like to receive help with your injections, call the Together with Tymlos Clinical Educator Network at
For any other questions about treatment, it’s best to talk to your doctor.
Like your local pharmacy, specialty pharmacies prepare and dispense prescription medications. Specialty pharmacies are able to manage medications that local pharmacies may not. They’ll usually process your prescription over the phone, then send it to you by mail. Find more information here.
“Osteoferocious” is an attitude that celebrates fierce, strong women who are ready to stand up to postmenopausal osteoporosis! If you’ve experienced menopause, talk to your doctor about postmenopausal osteoporosis. We’ve put together a helpful list of questions that can help guide your conversation on postmenopausal osteoporosis.