This presentation will review pathophysiology of postmenopausal and age-related bone loss. The role of BMD testing, in combination with clinical risk factors will be reviewed, and the current indications for bone density testing and for pharmacological therapy will be discussed. The revised recommendations for calcium and Vitamin D intake and the justification for the changes will be presented. Conventional therapeutic choices for treating osteoporosis will be presented, the benefits and risks of osteoporosis therapies, and an emphasis on the concerns about long term risks of bisphosphonates and the rose of a "drug holiday".