@psmnonna I believe most people do Reclast or alendronate after Tymlos. (Prolia is an option not considered by my doctors.)

It really depends on your DEXA at the end of treatment.

My femur neck was still -3.6 so I wanted to try a few months, at least, of Evenity. But if all my scores had done as well as my spine (up to -2.5 after Tymlos) I would have just gone on to Reclast.

My personal view is that it isn't that complicated. My doc wants something strong enough to "lock in" gains. In his book "Great Bones", Keith McCormick writes that HRT as well as SERMS (Evista) may lower bone turnover but don't raise bone density. My doc would not use them to lock in gains after Tymlos because he wants something strong enough. (And I have had breast cancer so can't do HRT anyway.)

So after Tymlos I have considered either Evenity then Reclast, or directly to Reclast. I respect all the avenues different people try and hope that people trying different things will come back on the forum with results.