@stacibw, I'm sorry you are a new member in this club that no one wants to join. It's a confusing diagnosis and there is so much information out there, much of it conflicting. IMO, the first step is to try to determine the root cause. In your case, it is undoubtedly the early menopause (loss of estrogen), but make sure your doctor does a 24 hour urine test (and other blood tests) to see if anything else is off (like too much or not enough calcium in your urine, parathyroid function, medications like corticosteroids, etc.). You have time to think even though your MD called this "aggressive" so I'd encourage you to research before you start a medication so you can feel as confident as you can about what is best for you - there are SO many considerations for each. It sounds like you will need a bone builder like Forteo, Evenity or Tymlos. You might also inquire about HRT since you are young and only a few years post menopause. Many of us have had to learn to be our own advocates and, at this point, I seem to know more than the MDs I've seen. Find a good endocrinologist or rheumatologist. You will also need to investigate diet and safe ways to exercise. I have learned so much on this site and also from watching particular YouTube videos. I really like OsteoBoston (here is just one example of a specialist who presented, but there are MANY) https://www.youtube.com/watch?v=zG_V6XPIDFU&t=751s. Others will weigh - this is marvelous forum and you are at the tip of the iceberg. Wishing you the best.

Here is an article about blood tests that can identify other possible underlying conditions:
https://www.medicalnewstoday.com/articles/blood-test-for-osteoporosis