Although there is a wide variety of osteoporosis medications with varying dosing intervals, adherence to therapies for postmenopausal- or glucocorticoid-induced osteoporosis remains poor. It is associated with long-term consequences, such as increased osteoporotic fractures, including nonvertebral hip fractures. There is a lack of understanding about why patients are not staying on therapy. Potential solutions include newer medications with extended dosing intervals, monitoring, and an open physician-patient relationship.