Several agents have been shown to be effective in preventing bone loss in postmenopausal women and in reducing fracture risk in patients with postmenopausal osteoporosis. Patients suffering from disorders or taking medicines (e.g., glucocorticoids) likely to cause or accelerate bone loss should ensure adequate intake of calcium and vitamin D or, in some cases, pharmacological treatment. In some countries, pharmacological agents licenced for the prevention of bone loss include oestrogens or combinations of oestrogen plus progestogens, raloxifene, tibolone and certain bisphosphonates (alendronate or risedronate) [1]Gregson CL., et al., UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. 2022. 17(1):58.

. In addition to these medications, conjugated oestrogens/bazedoxifene and other bisphosphonates (ibandronate and zoledronic acid) have also been approved in North America for the prevention of bone loss [2]Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society. Menopause. 2021. 28(9):973-997.

. They are administered at doses lower than those prescribed for the treatment of osteoporosis.

The concept of osteoporosis prevention with anti-remodelling agents also applies to the treatment of women taking aromatase inhibitors for non-metastatic breast cancer, who show bone loss and an increased risk of fracture.