Overall strategies

Calcium supplements, with or without vitamin D supplements, or calcium-rich diet

Weight-bearing exercise

Avoidance of alcohol, tobacco products, drugs and excessive caffeine

ERT within five years of menopause for 10+ years

Alendronate (Fosamax)

Raloxifene (Evista)

Strategies for patients taking glucocorticoids

Lowest dosage of a short-acting glucocorticoid or use of topical preparations whenever possible

Well-balanced diet, with daily intake of 2 to 3 g of sodium

Weight-bearing and isometric exercise to prevent proximal muscle weakness

Calcium intake of 1,500 mg per day and vitamin D intake of 400 to 800 IU per day after hypercalciuria is controlled

ERT in all postmenopausal women and in premenopausal women with low levels of estradiol

Measurement of BMD at baseline and every six to 12 months during the first two years of therapy to assess treatment efficacy

Treatment with calcitonin or bisphosphonate if bone loss occurs during treatment or if ERT is contraindicated