I have to admit I don’t know much about the range of options for building bone. It could be that with osteopenia you might not need a bone builder. Part of that answer is probably what is causing the osteopenia. Going into menopause you’re likely to lose more bone because of lower estrogen, but you might be able to control that with diet/exercise. Some people have a family history of osteoporosis and it seems to be some other body process that is causing it - even with a good diet and exercise the bone just loses density.

If you need a bone builder, then you’ll want to take it, but with some of those drugs you HAVE to stay on medication because when you stop the bone loss starts up again at a rather fast pace.
My sisters were able to do 4-5 years on alendronate and then stop. They are 71 and 75 yo now. I waited to take anything and dropped into osteoporosis. Fosamax caused stomach problems so I did Reclast last year. The oncology rheumatologist says I should do Reclast again this year then maybe every other year. Within 6 months of taking Reclast my spine recovered 6% of bone. But that isn’t enough for some people.

You just have to make the best decision you can based on health history, diet/exercise history (bone density drop in spite of good food/exercise?), past chemical exposures (lead, cadmium, etc), expected future hormone levels (low estrogen), and the doctor’s explanation of what is currently recommended, and what she expects in the next 20 years for keeping your bones strong.

Hi
I am 65 I had a fracture two years ago rolling over in bed in my spine at my t7 and my endocrinologist immediately put me on reclast or it's also known as zoledronic acid . I also had a lot of trepidation had a good talk with my pharmacist and I'm glad I did it because I'm on my third infusion this year and my bone density has come up a lot since starting the infusions now I've been diagnosed with dcis breast cancer and had two surgeries so I'm going to be starting radiation which terrifies me hopefully I'm ahead of the game as far as my bone density because I know my oncologist is only going to put me on 5 mg of tamoxifen because that actually helps build bone density from what I've Been Told. If I can give you a bit of advice regarding the infusions hydrate the day before with some kind of electrolyte water coconut water is a healthy option and I do two bottles the day before I take Tylenol the night before I take one bottle of electrolyte water in the morning and to Tylenol before my infusion and I have not had any side effects. Wish you well with your treatment.