Are you on any medications now for osteoporosis, or are you still trying to decide what to do? My latest DEXA scores were very bad, but I'm fearful and undecided about what to do. My Dr recommends a bone builder, but said I must agree to following up with Reclast or Prolia. I'm not happy about either of those two choices. I have daily pain from fibromyalgia and just want to put my head in the sand about taking any meds after reading the side effects. Part of me wonders just how effective any of the drugs will be for me vs side effects.

My humble understanding is that tymlos 'pushes - forces' the osteoblasts to build bone. After 16/18/22 months these cells do not respond as well to the medication. The osteoclasts are ramped up to 'dismantle bone' and this makes the 'bone coupling' ( 'building' compared to 'dismantling') out of sync.
Hopefully you have been keeping track of P1NP and CTX- bone markers. The 'bone building' rates can be checked thru bone makers ( P1NP ). When this result starts to wane compared to your history, then the medication is losing effectiveness. Tymlos is then stopped; a medication is given immediately for a short time to maintain the gains. Do not skip this step. I repeat do not skip this step. TYmlos was just apporved to be given again - how effective this is depends on many issues including bone markers and dexa and tbs. Make sure your endo is a BONE specialist. May you get good guidance and restore your bones to strenght and vitality.