The number of women affected by postmenopausal osteoporosis is likely to continue to increase substantially as the population ages. Furthermore, the therapeutic options for such patients are likely to increase. In this brief review, we outline the use of the currently available medications for the management of osteoporosis--namely, estrogen, calcitonin, calcium, and vitamin D. In addition, we discuss the next generation of drugs that are likely to become available in the future--the bisphosphonates and estrogen analogues. As these options become available, the prevention and treatment of osteoporosis will become similar to the management of other common disorders such as hypertension or hyperlipidemia, in which the most appropriate medication may differ for individual patients. Thus, the treatment of osteoporosis is likely to evolve from a decision of whether to initiate estrogen replacement therapy to a more complex decision of the best agent to use for an individual patient.