First line of treatment of osteoporosis in postmenopausal woman?

Hormone replacement therapy is cornerstone in both prophylaxis and treatment of osteoporosis in menopausal women. Estrogen delays and protects against osteoporosis by 50% in all skeletal and not limited to trabecular bones of spine, wrist and upper hip. Rest of the drugs used in H for osteoporosis are natural estrogens, progesterone, tibolone and raloxifene. Bisphosphonates may be used are primary treatment in late osteoporosis in postmenopausal women Bisphosphonates include: Alendronate, Risedronate, Ibandronate, Zoledronate. These agents chemically bind to calcium hydroxyapatite in bone and decrease bone resorption by blocking the function and survival but not the formation of osteoclast.