About 1.5 grams of calcium daily is recommended. Exercises that don't involve weight bearing, such as swimming, don't increase bone density. Estrogen replacement therapy is most effective when started within 4 to 6 years after menopause, but starting it later can still slow bone loss and reduce the risk of fractures. Decisions about using estrogen replacement therapy after menopause are complex, because the treatment may have side effects and risks. Raloxifene is a new estrogen-like drug that may be less effective than estrogen in preventing bone loss, but it does not have typical estrogen effects on the breast or uterus.
Treatment is aimed at increasing bone density.
Bisphosphonates are also useful in treating osteoporosis. Alendronate reduces the rate of bone resorption in postmenopausal women, increasing bone mass in the spine and hips and reducing the incidence of fractures. However, to make sure that alendronate is absorbed, it must be swallowed with a full glass of water the first thing on arising for the day, and no other food or drink should be taken for the next 30 minutes. Because alendronate can irritate the lining of the upper gastrointestinal tract, the person must not lie down after taking a dose for at least the next 30 minutes, until they have had something to eat. Certain people with difficulty swallowing or with certain disorders of the esophagus or stomach should not use it.