Lifestyle changes:
(1) Exercise regularly.
(2) Stop smoking.
(3) Do not drink alcohol to excess.
(4) Avoid tasks that involve heavy lifting.
(5) Minimize the risk of falls.
(6) Spend time outside exposed to the sun.
Dietary changes:
(1) Increase calcium intake, preferably as a salt that is easily absorbed.
(2) Avoid dietary factors that interfere with calcium absorption.
(3) Take vitamin D supplements if nutrition is poor, serum levels are low, or housebound.
(4) Eat a good diet, avoiding a low body weight for height.
Drug therapy:
(1) If the bone density is low, then consider therapy with a bisphosphonate.
(2) If the bone density is low and the woman has other indications for estrogen therapy, then consider estrogen therapy. Use of an estrogen in a postmenopausal woman should weigh the risks versus benefits.
(3) Discontinue and avoid medications associated with osteoporosis if possible. If required to use a medication associated with osteoporosis, use the lowest dose possible for as short as possible to achieve therapeutic goals.
