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Amino\u2010bisphosphonates, taken orally or intravenously, remain the dominant treatment modalities for osteoporosis. These so\u2010called anti\u2010resorptive or anti\u2010catabolic agents stabilize the skeleton and reduce fracture risk in osteoporotic as well as osteopenic individuals. A monoclonal antibody against receptor activator of nuclear factor \u03baB ligand, Denosumab, constitutes a new anti\u2010resorptive agent recently approved worldwide. In younger postmenopausal women, low\u2010dose estrogen or estrogen\/progestin still has a place for short\u2010term (up to 5 years) preservation of bone mass, especially in women with menopausal symptoms. Likewise, selective estrogen receptor modulators should be considered in younger postmenopausal women, especially those at increased risk of breast cancer. Anabolic (bone forming) regimens, of which parathyroid hormone is the only agent currently available, aid in the build up of new bone, increase bone mass and improve bone architecture. In cancellous bone, 30\u201360% increases of bone mass have been documented, but cortical bone thickness also increases. These improvements lead to profound reduction in fracture rates in both the axial and appendicular skeleton. 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