Managing osteoporosis: current trends, future possibilities.

The management of osteoporosis after fracture has occurred is currently difficult. The most effective approach is clearly prevention. Reduction in risk factors, adequate calcium nutrition, and physical activity are all important features, but the mainstay is estrogen therapy. Although this treatment early in the postmenopausal period has been shown to reduce bone and fracture, it must not be forgotten that other biochemical abnormalities in calcium homeostasis may also cause bone loss with aging. Despite the difficulties in treating established disease, newer strategies are being developed in the hope that increments in bone mass may reduce the frequency of fracture recurrence.