So, you’ve been diagnosed with osteopenia. Your doctor recommends a bisphosphonate – say, Fosamax. But you’ve read some pretty awful things about it.

From the rigid schedule for taking a bisphosphonate, to the heartburn, diarrhea, and nausea that may accompany it, to the awful possibility that it may dissolve your jaw… right about now, your inner self is probably screaming, “Don’t go there!”

But what’s a woman to do? You’ve been through menopause, and tests tell you your bones are thinning. Why is this happening?

Maybe you have a family history: your grandma was bent over nearly double by the time she passed; your mom broke her hip in her 80s.

Or maybe you have some lifestyle issues; you smoke, you drink, you’re out of shape.

Are you taking an aromatase inhibitor for breast cancer? Steroids for asthma or rheumatoid arthritis? Your bones are at risk.

But… do you REALLY have to go the drug route?

Maybe not. If you were deep into osteporosis, with T-scores WAY below -2.5, then yeah, you definitely have to take some kind of drug. But if you’ve had a bone density test, and your T-score shows you in osteopenia – what then? Take drugs?

Or take action?

Take a look at these 10 things to know about avoiding osteoporosis drugs. You may just be able to bypass the expense and irritation of a bisphosphonate.

1) Calcium. This is job #1: make absolutely sure you’re getting enough calcium in your daily diet, via food, or supplements. For women over age 50, that’s a minimum of 1200mg daily, with some doctors recommending 1500mg.

And, did you know there’s a wrong way to take calcium, and a right way? And that what you eat along with calcium affects how well it works? Familiarize yourself with this critical mineral, and make sure you’re getting what you need, when and how you need it.

2) Exercise. Yes, exercise makes a HUGE difference. But, while all exercise is good for you, certain types of exercise are much better than others for building bone. Weight-bearing exercise – anything that stresses your bones, like weight-lifting, jogging, sports that involve jumping or running – is much better for you than, say, swimming or cycling or walking, where your bones aren’t really undergoing any stress. Exercise regularly – and concentrate on the types of exercise that’ll really help your bones.

3) Vitamin D. This vitamin is to calcium what gas is to your car: without vitamin D, calcium just can’t get going. Vitamin D helps in the formation of a hormone, calcitriol, which in turn allows your body to absorb calcium. So insufficient amounts of vitamin D in your body prevent the most effective absorption of calcium.

While the current government recommendation for vitamin D is 400IU daily, it’s an accepted fact that new guidelines, to be released next year, will advise a much higher daily dose. A recent study disclosed that fully 70% of Americans are vitamin D deficient; we’ve got some catching up to do.