This document discusses osteoporosis, its pathogenesis, current treatment options, and potential future therapies. It describes how osteoporosis results from an imbalance between bone resorption by osteoclasts and bone formation by osteoblasts. Current treatments either inhibit osteoclastic activity to decrease bone resorption or stimulate osteoblastic activity to increase bone formation. First-line therapies are bisphosphonates and calcitonin, while PTH is used for high-risk patients. Emerging drugs combine anti-resorptive and anabolic mechanisms or target new pathways like sclerostin inhibition. Future therapies aim to have better safety profiles and reliable biomarkers for prevention.