I do agree that the HRT needs to be systemic to help maintain my bone density. I asked my rheumatologist this morning what she thought and she’d like to see me go on Reclast but thought HRT would at least keep my gains. I’d love to stay on Tymlos for a bit longer but the likelihood of insurance continuing to cover it after 2 years is highly unlikely. Let me know if I have any questions or wisdom to share as I prepare the this next phase of meds. Thanks